document r§sumi - ericobjeative 1 (see table 1, objective 1.1-1.4), the establishment of a...
TRANSCRIPT
. DOCUMENT R§SUMi
,
ED 227.620 EC 151 065.
TIM& San FrancsCo Infant Program. Final Progress Report,July 1, 1981-June 30, 1982. .
. INSTLTUTION San Francisco State Univ., CA. Dept. of*SpecialEducation.
SPONS. AGENCY Special Education Programs (ED/OSERS), Waihington,DC. Handicapped Children's Early EducationProgram.
PUB DATE 28 Jun 82GRANT G007900515 . -
NOTE . .320p.. ,
PUB TYPE Gui-des.- Classroom Use - Materials (For Learner)(051) -- Reports - Evaluatiye/Feasibility (142)
EDRS PRICE MF01/PC13 Plus Postage. -
DESCRIPTORS Behavioral Objectives; *Child Development;.
*Disabilities;- *High Risk Persons; *Home Instruction;1 *Infants; Instructional Materials; Minority Groups;
. Parent Eddcation; *Preschool Children; PreschoolCurriculum; Preschool Education; ProgramDescriptions; Teacher Education-
IDENTIFIERS *California (San Francisco)
ABSTRACTThe San Fran cisco Infant P rogram provides classroom
and home educationilprograms for handicapped tor at-risk) infants(0-18) months and toddlers (18-36.months)., parent.training, .
preservice and Anservice training, and research_opportunities. Thetransdisciplinary training focuses on the following skills: gross andfine motor,.cognitive,. communication; self-help, and social: A total:n:4of 41 children were enrolled during 1979-1982, with about 20partiapants per year. The program also: 1) established a moderforthe diagnosis, assessment, and'referral of Caucasian, Black, andSpanish-speaking clients; 2) trained parents to deyelop systematiclearning actii7ities With their children; and 3) measured infantbehaviors and parent teaching skills using standardized tests. Thestaff includes an infant and toddler teacher, physical and speechtherapists, and consultants. In cooperation with San Francisco State,Aniversity, students were trained in atypical infant development, andresearch projects were designed to validate curriculum programs forhandicapped infants. The subitantia1 appenaed materials include:sample infant curricula and a litt of curricular objectives; data onservices, training, and other program accomplishments; anindividualized education program fotm; data collection forms'forformulating infant educational plans; a master's thesis.on technigueSto train motor responSes with.severely handicapped infants; adescription of electronic,toys used to train a Down's syndrome ,
toddler; a student'training manual for special education (emphasizingseverely handicapped and eatly childhood) and a program descriptionemphasizing parent edudation and service.provision to a culturallydiverse population. (SEW.
Or.
t,
1.13, DEPARTMENT OF EDUCATIONNATIONAL INSTITUTE OF EOUCATION
1TED aTIONAL RESOURCES INFORMATION
CENTER (ERIC)
his documeht has been reproduced asreceived horn the person or organizationoriginatin6 it
Miner changes have been made to improvereproduction quality ._ _ _ _ _
Points of view or opinions stated in thisclocurnent do not necessarily represent official NIEPosition or pole"
SAN FRANCISCO IRFANT pROGRAM
DEPARTMENT OF SPECIAL-EDUCATION,
SAN-FRANCISCO STATE uNIVEgsIty
. SAN FRANCISCO, CALIFORNIA
FINAL PROGRESS' REPORT
JULY 1, 1981 JUNE*30, 1982
Handicapped Children's EarTy Education Program
U.S. Department of Education
Washington, D.C.
The Project reported herein was performed Pursuant to
'Grant No. G007900515 from the; U.S. Department of Education.
,The opinions expressed herein do not necessarily relfect the
.position or policy of the U.S. Department Of Education and
no official endorsement by the U.S. Department of.Education
should be inferred.
The r ort is organized in two sections. Secttep/
I, an overview includes a
brief review of program components and descripti9n of the project's current
1
status. Section 2 details ttie project's.accomplishments over the three year
4
funding period.
OVERVIEW
4,10
PROGRAM DESCRIPTION
S.
Maria S. is an 8 month old severely handicapped chil?who.has visual,
hearing and motor impairments resulting from a viral infectign during her ,
mother's pregnancy. Maria and her mother attend school weekly, Maria's
mother is learning to position And handle Maria in order to help her to eat
from a spbon and to move her arms toward midline. Mrs. S. is excited that
Maria is beginning to hold her.head up and take food frlom the spoori; she is
teaching Maria's older sister to assigt in the feeding. Mrs. S. reports.that.
she likes the school program and home visits because, for the first time,'she
is receiving concrete help in teaching Maria. She also looks forward to
parent meetings since she gets to take a break froM child care and talk with
other parents, a welcome.opportunity. to reeet new friends as her family lives
so fdr away in Mexico.%N.
Lamont is learning to match objects, to take turns in activities. such as
choosing and labeling teys when in a small. droup, to imdtate a_sequence of
movements, and to use words such' as "juice" to tell his teachers and parents ..'
what he wants. Lamont joins his classroom peers (some of whom are develop-
mentally typical and integrated into.the clas'S for delayed toddlers) in
school two times.per week. ,Nii father-attends the programwith him in.order
to coordinate and plamwith the teachers activities which will enhance Lamont's
learning and development. Mr. W. discusses Lamont's education plans with his
weife, who works during the day, so that they can together:implement the
activities in the home. Lamont is a 26 month old Down syndrome child. His
parents hope he.wili attend as normal a preschool and kindergarten program
as possible when he "graduates" from the infant/toddler project.
Maria and Lamont are representative of participants in the San Francisco
Infant Program. The program serves infants and toddlers from birth'to three. .
a
leears of age who have identifiable disabling conditions (ranging from mild
, to severe handicapping condttions). Families participating in the program
tome from all .socioeconOmic and racial.and ethnic groups (White, Black,'
.Hispanich Asian),representatfve of the San Francisco Population.
The primary goal of the San Francisco Infant Program is to provide
'early interventiOn services for these infants and their families residing '
in the Bay Area.
of.development:..
help and social.
Training is given to children across all behavioral areas,4
.grossmotor, fine.motor, cognitive, Communication, selfn
Parent involvement is encouraged through parent training
/.. and .support groups,
.
.Model Elements
The.San Francisco Jnfant Program Model combines several major tenets or
elements. These elements ihclude: 1) the provision of services utilizingA
a transdisciplinary model, 2) the systematic instruction to children through
a combination of a home and school based Program, and 3) a focus on the
child'sinteraction within the larger environment - the child's family.
The transdisciplinary model used in this context assumes that each staff
or interyption team member,. provides inpui from her/his own area of expertise
in the educational'setting. Input consists not only of individual child
assessment and education planning,.but also the training of" other staff
members" and parents to delivee these special services. For example, the
physical therapist maintains the primary responsibility for assessments and
recommendations regarding children's motor development. In addition, she
,
trains parents and other team members to position. therapeutidally,and
handle children to facilitate optimal.per'formance and learning in all areas.
She, in turn, has been taught by other team members to write behavioral
objectives for'her teaching programs and to utilize communication facilita-
tion techniques.
The transdisciplinary servicedelivery moael is..timplemented at a program
location dontdted by the San Francisco Unified School District through a
collaborative arrangement with'San Francisco State UniArsity. Infants and
toddlers with their caregivers both attend a school program and receive home
visits periodically. The combtned home and school programs focus on assisting
parents to develop sys'tematic leareng,activities with their children and onN
enhancing the interactions of infants and toddlers with their parents,
siblings and other caregivers.. Thus, intervention is construed as a network
of educational, iriformational and support services for the child and family..
Services to Children
The twenty children participating in the San Francisco Infant.Project
are placed in in§tructional groups on the basis of chronological age.
Infants who'range in age from birth to 18 months are divided into two groups
of five and attend school once a week for three hours with their parent(s)
or primary caregiver (e.g., babysitter, grandparent). Toddlers (18 months -
36 months) attend school two-three mornings per week, accompanied by a
,parent-caregiver.Additionally, allehildren and familtn are visited in
their homes biweekly by staff members.
Child change and development is measured on.two formal instrumpts, the
11
Bayley Scales of Infant Development,and the Uniform Performance Assesment
System (ITAS). Additionally, continuous measurement of-child acquisition
1'7
4
of target goals.is taken on'a criterion-referenced checklist corresponding.
to the program's curriculum objectives (objectiv.es and programs represent a
compilation of existing nationally tested infant/toddler'curricOla)..
)
Services .:to ramilies
Parents are viewed as active participants in'the educational process,
functioning both as pianners and teachers of thOr children. Parents in the
San Francitco Infant Program receive assistance in designing and implementing '
training programs for their children. Parents also are offere'd information on
coMmunity resources and referrals for specialized needs.. Two types of parent
groups are availaple.to Infane,PrOgram participants in addition to the classroom'
component. The focus of one parent group is on providing support and counseling;
the second group meets for workshops on,topics selected by parents. Parent's
respond to a parent "consumer" satisfaction measure twice annually to deliver. .
specific feedback to the staff on program services:,
'Staff
The transdisciplinary team,of the San Francisco Infant Program consists
of the following members: Project Direct, Project Coordinator, Infant/Toddler
Teacher, Physical Therapist, Speech Therapist and Parent Coordinator (part-time)
and medical and psychological consultahts.. Biweekly staff inservice training
sessions are held.
.e
PROJECT STATUS
al
The San Francisco Infant Program pas been funded through the.California
State Department of Developmental Servojces as a vendor fOr the Regional
Center System to provide services.to developmentally disabled infants and
toddlers. As such, the program will continue to fully oper as it has
for the past three years.
The program hqs been recogniAd as a major incant/toddler program in
the Bay Area, particularly as a program which provides services to multi-.
cultural children and families. The training and dissemination activities
begun through the federal demonstration funding are being continued and
represent a unique and major contribution to the Bay Area. The summa6
of program accomplishments is detailed in the following section.
-/
;
6
4 \
'PROJECT ACCOMPLISHMENTS
Project accomplishments are organized and presented by specific program
c9mponents, Project objectives dnd activities are detailed in Table.l.
All objectives were met as specified i4 the proposed timeline. A. numerical
summary of accpmplishments is provid0 in Table 2.
SERVICES TO CHILDREN
Objeative 1 (see Table 1, Objective 1.1-1.4), the establishment of a
combination o4assroom and homebased infant and toddler'program, was accom-
plished during Year 1. Activities 1'-8 and 12 and Diittames, 1-3 'under Objective
1 were initiated during Year 1 and continued in Year 2.
Year 2 activities focused primarily on expanding the toddler.(18-36
month old) program. During Year 3 the program was expanded.even further to
include two toddler. and twp infant groups.. Emphasis fo'r toddlers was placed
on pre-academic and preschool 1.:eadiness skills so that children were prepared
upon "graduation" for public school preschool programs. Traditiona.1.140,public
school preschools-in the San Francisco Unified. School District have been
segregated. Through the efforts of school district personnel, Wefts in our
infant/toddler program and our project staff, two new preschool programsP.
were eitablished for "graduates" of our intervention program. The new programs
provide opportunities for integrated activities with nonhandicapped children
forat least half of their school experiences.
A total of 41 children were enrolled in the program from1979-.1982 with
approximately 20 children in the program in a given year. Table 3 lists tné
disabilityband ethnic groupings of children served throughout the)three year
period. Ai these data indicate, the sample of families seryed by the infant/
toddler program reflects the diverse, multicultural population of San Francisco.
6
re.
P
Follow-up interviews have been conducted with the families of all chilcAn
who have graduated from the program. Of fourteenAraduates, four were placed s
in programs in the Bay Area-for the'severely handicapped, one in a program for
the orthopedically handicapped, seven in noncategorical programs for preschool
children with special needs, and'twoi ire enrolled in regular preschool programs.
All children have contact with nonhandicapped children for some portion of
their school day. The staff of the San Francisco Infant Program have worked
with parents and San Francisco Unified School District personnel to achieve
placemelts in the least restrictive environments for these children, environ-,
If ments that uovide the same academic training and integrated opportunities
children experienced in our toddler program. As/was previous)y discussed,
these efforts have resulted in impuved relations with the school distritt
for infant programs in tne city.and a great expansion in the program options
available to preschool aged children with special needs.
Of the other children at one time enrolled in the prOgrain, eighteen are
continuing because they have not y.g.4 reached age three; two are deceased, and
six*mdved to other cities. Additionally, during Years 2 & 3,seventeen and
eleven childrenrespectively were referred to other agencies by'this program
beLuse the number of staff could not accommodate a larger number of children
and/or because another placement was more appropriate for the specific child
and amily.
Referral arrangementsestablished by the Project DireCtor (Dr. Hanson)
during Year 1 (Activity 5, Objective 1) Were continued throughout the three'
year period. A total of 79 children were referred during this time with
referrals ?ming from a variety of agencies including: University of California
Medical Center, Mt. Zion Ospital, San Francisco General Hospital; St. Luke's
'Hospital, Golden Gate Fgiona1 Center, the local DeveloPmental Disabiliqest
r
,
,
. ,
Council, Department of'Social Services, California Childrens' Services,
other infant programs in the city, Down's Syndrome League, public health
.'nurses, and local pediatricians.* A program flyer was printed to-iacilitate
ttie referral process. Given the need in t'hiscity forgervices to youfig..
isabled children, especially those from multicultural and disadvantaged
homes, refereals wer'e continuous durivethe three year period..
A review of available infant curricUla was conducted and components of
euh selected for use in tits program (Activity 10, 06jective 1). These
curricula included-the Portage Project; the ,Oregon Project for VisuallyI
Impaired and Blind Preschool Childr'en, Hanson's Teaching Your Down's Syndrome
Infant:-A Guide for Parents, Finnie's Handling the YoUng Cerebral Palsied
Child at Home, the University.of Oregon Cecter of Human Development Preschool
Curriculum Guide, Hawaii Early Learning profile (HELP) Guide, and the HI Comp
Project Curriculum. Additional eaily intervention curricula were collected
and were available as.references for staff for use in the dev lopment of
each child's individual education plan. From these'resources staff membeA
,
compiled a comprehensive curriculum for the infant and toddler programs by
identifying, modifying, and supplementing relevant/approaches, activities and
strategies from these existing curricula. Samples from this curriculum are
included in Appendix A. Appendix B provides a list of curricular objectives\
1
and Appendix C presents a copy of the Individualized Education Program form.
4
I
g
4,
PARENT/FAMILY PARTICIPATION.
Objective 2 (see Table 1, Objective 2.1-2.3) was begun during Year 1 and
continued in Years 2 and 3. Since parents were viewed as active participants
in the educational process, they functioned both as planners and teachers of
their children. Relevant literature was reviewed (Activity 1, Objective 2)
and a system for formulating infant educational plans in conjunction With
the.child's parents was devised along with progriff sheets and data collection
forms (See Appendix D). Parents received assistance in aesi4ning and imple-
4)
-menting training programs for their children 1-2 times pel- week (Activities
2 and 3, Objective 2). Additionally, parent support groups were formed and-
met biweekly for discussion and counseling (Activity 4, Objective 2'). One
. parent groulikalso requested formal presentation on child behavior management
and child development during this group time. Therefore, these topics were
covered in addition to regular discussions of problems and issues in the care
of a handicapped child. A second type of parent group was established as well.
This group met peniodically in evening or afternoon workshop sessions with
invited speakers. Topics covered included:
1) Public Law 94-142 and parent and child education rights
2) The IEP process and how to work with the school district
3) Speech and language development and facilitation strategies
. Pediatric care and Common questions
. 5) Seizure disorders
6) Controversial therapies
7) Supplementary seniices in the Bay Area
8) Construction of toys,and infant materials
3
These groups provided an informal setting in which pardas could be'come
better acquainted with one another and also acquire new information.
Families participating in the infant/toddler program represented diverse, w-
multicultural backgrounds as well as various family constellations. Thus,o.j
parent groups were planned to serve single mothers, single fathers, two parent
families, extended families and foster families, most of whom dyfer culturally\
from one another. Through multilanguage and multicultural staff members and
.tremendous flexibility,we accomplished the task-o't meqingt the needs of this
diverse group. Attendance at parent meetings and feedback from parent's. inli-
cated parent satisfaction with ihi's,program component. ,
10
11
ASSESSMENT OF CHILD PROGRESS. AND.PROGRAM OUTCOMES
Child Behavior Change -
Evaluation of Program-outcpMes included multiple methods (Activity 11,
ObjeCtive 1). Child progress waslineured by use of two standardized insiru-,
ments-, The Bayley Scales of Infant Development (Bayley, 1969) and the UPAS
(dnifOrm PerformanceAssessment System) (White, Edgar & Haring, 1978). Both
were administered at the beginning and end of the school year. Additionally,
continuous measurement of child acquisition of target goals was made on a
criterion-.referenced,instrument, a checklist of objectives,tied specifically
to the prograM curriculum items. Child change data for Years 2 and 3 are. .
presented in Table 4 (Bayley data),.Table 5 (UPAS data) and Table 6 (Curriculum,
Objectives Checklist data). All analyses employed a comparison where each
subject was measured twice.. Pretest (September-October testing) and postest
(May-June testing), comparisons were made 4tilizing a t-test for correlatdd
means. pre-postest analyses yielded significant differences for-all measure.
Thus, these findings suggest that children participating in this early inter-
.%tendon program did change"over the course of their program involvement.
These findings are remarkable in light of the fact thattchildren were
compared as a goup and not divided and compared by categories of severity
levels. Thus, feverely, multiply handicapped children were included in these.
:analyses. Given expectations that these children would progress in smaller
increments of change, remain Aable, or regress as measured by standardized
behavioral assessments, it follows that these scores would affect the group
-scores as a whole. Nevertheless, significant change were noted for all
pretest-postest comparisons.
Single subject research designs (principally multiple baseline designs)
12
also have been utilized to establish the relationship between infant skill
training efforts (performed by parents) and infant behavior change (Outcome4
6, Objective 1 and Outcome 2, Objective 2). Six'multiple baseline destgns
are presented in Figures 1-6.. These designs show that child change was
integrally linked to experimental educational procedures. Baseline behavior
across all target skills,indicated low behavior rates: Acquisition of these
skills occurred only when'training procedures were implemented (as indicated
by the dotted lines). Numerals denote phases/steps in the training plan
(derived from a task analysis of kach target skill ). Behavior gains mere
4
maintained as ihown by follow-up data points.
Parent Behavior Change
Data on parenting behavior (Outcome 2, Objective 3) atilizing the P'arent
Behavior Progression Scale (PBP) (Bromwich, 1981) were col3ected at the beginning,
(pretest) and encl. (postest) of the school year (see Table 7). Analysis of these
data using a t-test for correlated means yiplded statistically significant pre-
post test differences. Thus, participation in the early intervention program
did appear to positively affect parent behavior as increases in scores on the
PBP represent more adaptive parenting skills, skills.geared more closely to the
children's developmental levels and needs.
Program evaluation procedure also included the gathering of demographic and
descriptive data on chidren and families served and amount and degree of their
participation. Further, a parent "consumer" survey form was developed as a
measure of program outcome; thii form is an adaptation of the Parent Reaction
questionnaire development by Project KIDS, Dallas, Texas. Tables 8 and 9 present
for Years 2 and 3 respectively the number and percentage of parents responding
to each survey item. Results clearly showe satisfaction with the program by
participating families.
INSERVICE TRAINING FOR PROJECT STAFF
Inservice training for project staff (Activity 9, Objective 1) was .
conducted'both ini..-umlly on an ongoing basis and through formal sessions
by the Project directoi., staff members, and consultants. The training.
sessions were-held .on a biweekly basis. (Staff met as a group weekly also
to discuss program issyes.) Training topics Included: writing- behayioral;4.'
objectives, curriculum development, teaching concepts, asiessment of child
progress, facilitating and structuring parent partidipatiori: structuring
the classroom environment, record keeping and,data gathering procedures,
interdisciplinary team collaboration, CPR, motor development, positioning
. and handling, and single subject research designs. Given that presenters
for the most part were staff members, these,inservice sessions pftvided a',
formal method for traininig transdisciplinary staff members in each' other's
P.
area. Additionally, WESTAR provided-project consultation for staff training
on evaluaVn issues, language developients and feeding program development,.
%1/4
Finally, staff attended the SFSU course; Atypical Infant Development,taught
by Dr. Hanson and workshops.offered 4n the Bay. Area for infant program
personnel.
1
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14
TRAINING FOR PERSONNEL FROM OTHER PROGRAMSN,r AGENCIES
. A 'major component of the San Francisco Infant Program was its collaboration '
with the Department of Special Education.at San Francisco State University
(Activities 1-3, Outcomes 1-3, Objective 3). Contacts were made with facultY
and SFSU through informal-discussions and through prventations made by Dr.
Hanson to the Special Education faculty. During Year 2, one Doctoral student
and eight Master's degree students in Special Education, three nursing students,
two physical therapy students and one Master's student in Psychology received.'
training in the infantiprogram. During Year 3, five Doctoral students and 35,
Master's students (primarily ifi'Special Education) and two medical students
trained in the program. Student,teachers trained in the project for a minimum
of one semester and received instruction on curriculum delielopment, educational
planning for indiyidual children, working with parents, and data gatherjng.
Other students received training ranging from one day to 20 hours/week depending
upon their courseWork assignments and project schedule.
During Year 3, the San Francisco Infant Program was selected as ne of
ten training sites in the state of California bS, the State Department of
Education, Special Education Resource Network (SERN). The purpose of the
Infant/Preschool SERN is to provide inservice training in early childhood
special education to programs (both public and private) serving infants and
preschoolers with exceptional needs and their families throughout California.
Our peogram was chosen aS an inservice site and provided trainirig to early
educators throughout the year. Training time varied depending on type of
assistance requested by the trainees.
The San Francisco Infant Program in conjunction with the Department of
Special Education at SFSU also sponsored a conference entitled "Visual and
15,
Auditory Assessments for Preschool Aged Children". This cohferenCe was held
'at San Franciscq,State University in 1981 and was attended by more than 80
Oersons in the field coming from throughout the Bay Area. This topic was%
determined to be of Agreat interest by participants in the West Bay Infant
Consortium. As active participants and former chairs of the Consortium,
..
the staff members of the San Frari6isco Infant Program volunteered their time 0
to provide the conference in response to this.Consortium Needs Assessment.
16
RESEARCH
Research activities (Objective 4) related to curriculum validation and
structuring of responsive environments for infants was begun during Year 2.
One Master's thesis.(Study 1) comparing traditional therapy techniques and
the use of adaptive Oevices to train motor responses.to severely handicapped
4
infants was tompleted. That thesis is included in Appendix E. ,
Three related investigations also were conducted. In Study 2, a moderately
handiCapped child (3 year old with Down syndrome) wai taught three new skills ,
with the use of electronic equipment. Three training situations were constructed:
an electronic puzzle 'toy, an electronic doll, ag a matching task. The elec-,
tr:onic toys are descrObed in detail-in Appendix F and plans are proVided.
multiple baseline desigh'was utilized'to establish relationships between behavior
change and the treatment program: Trleatment 1 consisted of prompting the child
to fit a puzzle piece into an electrOnic puizlg which lit up.when two'consecutive,
noninterlocking puzzlg pieces were placed. Treatment 2 invotved the use of
shaping techniques in a standard teaching situation p teach the child to match
a common object with pictures of the same class.of Objects (e.g. match 'Moe to
pi.cture of a shoe). Treatment 3 incorporated a plastic stand-up doll equipped
such thatUen the child was asked to find a body part (e.g. "find eyes") and
'respond correctly, the teacher would activate the doll to light up. Figure 7
<*presents the results from this study. As can be seen, training was integrally'
linked to child mastery of the tasks.
In Study 3, a severely, multiply handicapped infant (age I year) diagnosed
as deaf, blind and functioning at the brainstem level was taught an operant-
kick response. This child had previously demonstrated no voluntary purposeful
movements. Data from this study, 'utilizing an ABAB design are presented in
17
Figure 8. The child was placed on a vibrating mattress pad connected to a
plexiglas kick panel. During baseline (BI) the child had free leg access
to.the panel, but a kick was not consequated in any way. In the treatment
phase (TI) a;kick was consequated by 3-5 seconds of mattress vibration.
Few kicks were made durflT T1. The mother indicated that the bulky diapers
'may have disrupted kicking responses. Therefore, the child's diapers were
removed for all subsequent sessions. Baseline conditions were re-instituted
(days 22-24) and followed by a second treatment phase and again by baseline.
Data from.these latter baseline-treatment-baseline condi6ons (Figure 8)
'establish a link between treatment utilizing the kick panel feedback system
and the,child's kick responses. Further,replications are being conducted
with this child using the kick panel and other types er feedback stimuli.
Study 4 is currently underway. It incorporates a pressure 'Sensitive
panel switch for use by a young severe handicdpped infant to sighal the
parents (e.g. bring the parents to her). Upon pushing the panelyithia
very light touch, this severely, physically disabled year old child is-
learning to call 'her mother to her. No other signal.ling ressonses (e.g.
vocalizing, gesturing) are available to her due to the severity of her
disability.
Upon completion of all studies a paper witl be submitted for publication
in JASH (Journal of the Association for the Severely Hahdicapped). A second
paper describing the equipment utilized it being prepared for submission to
A
journal,Teachinq Exceptional Children.
DEMONSTRATION AND DI SEMINATION ACTIVITIES
18
. -
Agencies a d university training programs were informed on a continuir6
basis of the 'demoristration responsibilities and capabilities of the San
Francisco Infant Program (ACtivity 1, Objective g). Agencies contacted included
infant psograms in San Francisco and around the Bay Area, Golden GatellegionalNI,
Genter, hospitals and medical facilities,and the,State Departmeq of Education
as well as the San Francisco Unified Schbol District. Additionally,.Dr. Hanson.
was in adjunct member of 6e Slate'Task FOrce'to developeaching credential
for early intervention R:rsonnel. Members of this task force were selected
from major early childhood teacher.trajning programs, universities interested,
in starting early education training programs,, and infant programs.throughout
the state. This group repreented a'pnt%t pool'for deftristktion/dissemination
'Activities. Staff members also were activ ly involved in the West Bay Infant
Program'Consortium, a group of all West Bay Area infant pibg'ram personnel. One
purpose of this group(is to exchange information acro'ss programs, making it an
idei targstjor demonstration/dissemination activities. ,Dr. Hanson was
Chairperson ofthis _consortium.
During Year 2, Dr. Hanson gave five formal and five informal presentations Ae
to education and 'medical agency personnel in San Francisco. Abditionally, a
number of visitors were given an introduction to the early interVent'ion serviCes
*
offered by this project. ViSitors included 34 graduate students in Special
Education, two professors, five teachSrs, six education specialists, and four
medical and nursilstudents (Activity 3, Outcome 2, Objective 5).. In the
second year of project operation 595 persons were instructed on program
components and early intervention services.
- During Yeir 3, staff members mate eight formal and twelve informal
r-
4
19
presentations and 61 visitors attended the program ( 4 teachers, 3 eduCational
administrators, 3 physical therapists, 3 occupational therapists, 2 speech
therapists', 4 social workers, 4o Doctoral and Masters level students in
education and psychology, and two medical residents). In the third year the. "
project components were presented to 786 persons.
. During Yelc': 2 and 3 ihe program has functioned as a training site for
student teachers in special educatIon (severely handicapped and early childhood +4-
emphases). The student training manual utilized with these-students isa
. appended in Appendix G.
Staff members are active also in the California Consortium of First Chance
projects, egroup committed to the enhancement of services for young handicapped
children in the state of California and advocacy for ,early intervention services.
Dr. Hanson is serving currently ai president of this organization.
Additionally, the San Franciscb Infant Program was selected as one of ten
training sites in the state of California by the Special Education Resource
Network (SERN). Trajning was provided during Year 3 for infant program
.personnel in the state (ActivitY 2, Outcome 1, Objectjye 5).,
Finally, a written description of the program with particular emphasis on,
dix
parent education and the design and implementation of services for 'a culturallyt
4 diverse populatidn wat completed (Outcome 4, Objective 1 and Outcome 1, Objec-t,.
tive 2). This report appeared as a paper in Topics in Early Childhood
Education (Hanson, 1981)(see Appendix H).
4
401
:e
4
COORDINATION WITH OTHER AGENCIES.
20
'The 'Project Director,'Dr. Hanson, met with each of the major infant
.programs in San Francisco (Children's Hospital Child Development Center,
Variety Club Blind Babies Foundation, Easter Sear,,and Family Developmental
Center), California Children's Services, Department of 'Social'Services, the
lodal Developmental Disabilities. Council, and the Golden Gate kegional Center
to formulate plans for child referrals and exchange of services when appropri-.
ate. The'Regional Center's funciion ii to provide a compTete assessment of
disabled children (including medical, psychol gical, social work, speech) ahd
refer children to appropriate services. As ch, it was necessary for this
program to establOsh close, workable ties with this agency. Coordination with
*the school district was inherent in the designed project in that the effort
represented. a collaborative arrangement with the San.Francisco Unffied School
District (Activities 2-4, Objectivej). Project participation in the West
Bay Infant Program 'Consortium also qdilitaied interagency cooperation.
2 2
I. 21
RkPLICATION
/ A pilot replication program was begun duHrig Year.2.with the DeVoss Infant
Program in San Jose (Outcome 1, Objective 5)., These replication activipik
were expanded during Year 3. Data on the progress of children_in the repl.i-
cation program as mtasured on the UPAS and the Project Curriculum Checklist
are presented in Tables 10 and 11 respectively for Year 2 and in Tables 12 and
13 respectively for Year 3. Members of the DeVoss.staff received inservice
training at the San Francisco Infant frogram and monthly consultation from. ,
program staff. These replication activities assisted the San Jose program .
-
particularly in the areas of curriculum development and planning and implementing
a parent involvement program. Prior to reppcation tctivities, thesSan Jose
program had no formal parent involyement. Thin, this replication effort Was
successful in expanding,services to multiply handicapped infants and their
families.
234
CONTINUATION
As of July 1, 1982, the San Francisco I1nfant Program was approved to
rqbeive funding from the State Department of Developmental Services to
provide child treatment services. Theorogram as such is vendorized through
Jib
the Regional Center system to serve developmentally delayed clients. This4
funding allows for the continuation of the program at the'same level ai that
provided by this federal demonstration grant.
fr
F4
4
.11
22
't111 "
I
23
REFERENCES
Bayley, N. The Bayley scales of infant development. New.York: The
Psychological Corporation, 1969.
Bromwich, R. Workins with sarents and infants: An interactional
approach. Ba timore: University Par Prgss'1981.
Hanson, M.J. A model for e4xly intervention with culturally diversesingle arid multiparent families. To ics in Earl Childhood
Special ucation; 1981, 1(3), 37-44.
White, 0., Edgar, E., and Haring, H. Uniform Performance Assessment
k_§.n. College of Education, Experimental Education Unit, ChildDeVacipment and Mental Retardation Center, University of Washington,
Seattle, Washington, 1978.
a.
0.
II
I
.1
I
4
TABLE 1
ta,
4
.,
\
2
o
lb
:
0
r
J
P
OBJECTIVES
1. To establish a model demonstration_educational service delivery system tal_atypical infants, age 0-3 in the San
Francisco Unified School District, asa joint responsibility of the SanFrancisco Unified School District andthe SFSU Department of SpecialEducation.
1.1 To establish a classroom and. homebound educational program orhandicapped (or at-risk) infants0-18 months.
1.2 To erAabliSh an atypical infantclassroom in a public school facilityin San Francisco for handicapped (orae-risk) toddlers 18-36 months of
age. (Year 2,Objective).
1.3 To establish a service mbdel
including comprehensive diagnosis,assessment and referral of equalrelevance to caucasian, black andSpanish-speaking populations inSan Francisco.
1.4 To establish a transdiscipli-nary educational service model.
21
rAmt I
ACTIVITIES
1. Recruit and hirestaff.
2. Select-public-school-facility andnegotiate classroom space.
3. Obtain program approval from theS.F. Unified School District Boardof Education.
4. Procure necessary equipment (desks,cbairs, tables) from school districtand instructional materials from othersources.
5. Contact,hospitals, neonatologists;pediatricians, Regional Center, otherinfant programs, and DevelopmentalDisabilities Council for referrals(program flyer printed to provideinformation to these contacts).
6. Offer services to infants frombirth to 18 months.
7. Offer services to toddlers from18-36 mOnthi (Year 2 Activity).
8. Identify Advisory Committeemembers and organize regular meeting
times. Assign and divide responsi-bilities.
9. Establish regular staff inservicetraining.sessions to include exchangeofstraining information among disciplines.
10. Review available infant curricula
* and select appropriate components inorder to serve target population.
11. Evaluate program outcomes by
multiple methods: standardized
instruments and continuousmeasurement.of infant behaviors
and parent teaching skills.
OUTCOMES c
1. EstablishMent of atypical
infant classmith the S.F.Unified School DiStrict.
2. Receipt of child referrals froma variety of sources withtn S.F.
3. Identification of 15 infants(ranging from severely, multiplyhandicapped tb developmentallydelayed) and provision of,servicesby June 31), 1979.
4. Written reports detailingtransdisciplinary educational ,
model operations (includinginservice training).
5. Written reports documentingchild progress.
6. At least 20% of child programsto include experimental designswhich evaluate causal relationshipsbetween intervention procedures andbehavior ;change.
26 (it
1
..TABLE i
0 .
,1
OBJECTIVES , ACTIVITIES OUTCOMES.......,
12. Establish record keeping system'(ensuring confidentiality) and
. managemeni procedures (division of. responsibilities among.staff).
.
I
4
k
I
,
..
,
,
-,*
,
,
,.
,
4'm
*
OBJECTIVES
*1ABLE 1.
ACTIVITIESOUTCOMES
2.. To establish a parent instruction, 1.. Review literature relevant to 1. Brief written reports
counseling and.referral system as a the development of objectives, detailing procedures.
component of the educational service.
systeni.2. istablish a parent program of 2. At least 20% of training
-,
continuous infant skill training programs performed to include
: ..
=-2.1_ To offer parents information on their Lincludes_curriCulum and measurement experimental designs,which
rights and on infant services and resouives . SI/Ste-tilt).---------evaluate-ca9salL-relationship.s
on an indjvidual and group basis in their nativebetveen intervention propedures
- language.3. Conduct reguiar training sessions and behavior Change.
,
with parents. .
2.2 To off& parents a compreheniive referral3. Descriptive data on
. service for specialtzed needs relating to 4. Yrovide a parent support group parenting behaviorand home
: Infant care..
(group meeting at least monthly) factors and behavior.change
7...
a. Parent instruction on . as it is related to interventiori=
"2.3 To offer parents instruction on infant specific topics and counseling program. ,...
training activities apd measurement .
of prpgress with their atypical infants.b. Advocacy and information
on client rtghts and services
available.
c, Ongoing referral service
for specialized needs.
.
OBJECTIVES
3..'To establish a program in Conjunctionwith SFSU to assist in the preparation oftransdisciplinary personnel for handi-
capped infant.program§ in California.
3.1 To assist in the development of a'trainingmodel to iflclude'nursing, special educationspeech, and developmental therapies and
pedtatric Medicine.c,
3:2 To assist in the provision of apracticum training experience as a.component of the SFSU training model.
TABLE 1
. ACTIVITIES
1. Offer training in atypical
infant development through the
Department.of Special Education at
SFSU.
2. ,Contact faculty memberg in other
related disciplines and establiSh
ties to coordinate course offeringsto students.
a. Provide practicum setting forgraduate students.from specialeducation and related disciplines.
OUTCOMES
1. Surse entitled "AtypicalInfan Development" taught by
+fans n.at SFSU. .
2. Provide students vdth course-
offerings in.other departments
to include nursing, Communicatiodisorders, ghysical deVelopment,
as well as tpecial edUcation..
3. Students (special educationmaster's and doctoral level) and'
graduate students from.igelateddisciplines participate in the
S.F. rnfant Program to hceivetraining.
1
3.4 1:1
. , .
OBJECTIVES
4. To establish alOogram in.conjunction withSFSU and U.C.. Berkeley to assist in theprovision of a research Facility for thevalidation pf assessment and curriculumprograms for handicapped infants.
.
4.1 To assist the SFSU Department ofSpecial Educat,ion in.transdisciOinaryresearch effets aimed at curriculum validationactivities by providing alaboratory forthe controlled ttgdy of infant assessmentand training.
oTA BLE 1
o
ACTIVITIES OUTCOMES
v
\
1. Design of retearch projects 1. Written r s and .
related to assessment and curriculum, professiona art cles.validation.
2. Design of research projects
related to structuring of responsive
infant envircihment particularly
the construction of adaptiveequipment.
,
,
2. Presentations atprofessional conferences.
.,
t
3. Dissemination of findings
to professionals and parent(where appropriate) community.
,.
,
OBJECTIVES
5. Demonstration .;nd dissemination oftrajning model to i'nfant program personnel,.eAcation graduate students, medical .
personnel and other interested professionalsand laypersons.
TABLE.1
ACTIVITIES
1. Contact mental health algencies,
school Ostems, state agencies, .
universities, and other infantprogNms to recruit personnel andprogram staff interested in
receiving training in this model,
.2. Design on inservice tra.ining
program for persons who work
directly with handicapped ityntsand their families..
3. be ion systematic'visitorobserv tion system,
a
OUTCOMES-
1, Provide indepth.tr'aining
pro9ram to persons who upon
completion could replicate theprogram or components thereof.
2. ,Provide observation opportunitieS
for persons to learn about early
intervention programs,
36'
I
31
Activity
Table 2
NUMERICAL SUMMARY OF ACCOMPLISHMENTS
Year 1,
(1979-80)
Year 2 Year.-3
(1980-81) (1981-82)Total
Services to Children
Infants/Toddleri Screened
Infants/Toddlers Served
Services to Families
Family Members Served
Number of Sessions
Staff Development
Hours of Staff Training/Inservice
.Student Placements/VolunteersReceiving Training
Hours of Student/VolunteerTraining
Training for Personnel fromdirer Agencies
Personnel fr9m Other Agencies
Demonstration & Dissemination
Activities
Formal Presentations
Informal Presentations
Visitors to the Program
Persons Receiving Instruc'tion
on Program,Components
Repl icati on
Children Served atReplication Site
31
19
40
962
101
8
372
6
7
49
120
24
18
29
1724
262
15
1788
5
5
51
595
8
24
28
2774
84
42
1612
19
'8
12
61
786
8
79
41
125
5460
447
65
3772
31
19
24
161
1501
16
. 33
c.
r
TABLE 3
o
34
Table 3
ChildrenDemographic Data
1980 - 1982
1
Child Date of Entry Years in Program DisabilityWeas of Delay Ethnic Group
1 1/23/80 1,2,3 Down's Syndrome WhiteCongenitall Heart Disease .
Cardfac Surgery
2 1/23/80 1 Down's Syndrome. : .White
Heart Defect
3 1/31/80 1 -Down's Syndrome . _WhiteCardiac Surgery I
4 2/6/80 1,2,3 Severe Developmental Delay HispanicMicrocephalyHypotonia
HypercalcemiaVisually,Impaired
2/6/80 1,2,3 Motor Delay Hi.spanic/White
Hearing ImpairedVisually Impaired
Gastrointestinal ProblemsPossible Child Abuse
6 2/6/80 1 Cerebral Palsy
7 2/13/80 1,2,3 Developmental DelaySeizure Prone
Visually ImpairedHearing Impaired
Stereotypic*Behavior
8
9
10
11
2/19/80
2/21/80
2/27/80
3/1/80
1
White
Hispanic
Cerebral Palsy Black
Speech and Language Delay
1,2,3 Premature White
Cerebral PalsySeizures at BirthVisually ImpairedHearing Impaired
1 'Developmental Delay Hispanic
Speech and Language Delay
1 Down's Syndrome White
Cardiac Surgery
42
,..
Table 3
.. 35
Chld Date of Entry Years in Program Disability/Areas of Delay Ethnic'Group'
A12 3/25/80 Scoliosis White
Surgery - Gastrostomy tubeMissing Limbs
N Visually Impaired
13 4/7/80 1,2,3 TwinMicrocephalic-
SpasticityHealqng Impaired (Oestionable)
- , Visually Imprired
..,-
14 5/7/80 1,2,3 Down's Syndrome, White
15 5/21/80 Developmental Delay White
Chronic Ear InfectionDislocated'HipAbnormal Affect
Eye Surgery (congenital esotrophia)
16 5/22/80 Spastic Diplegia Black
Motor Delays.Speech Delays
Probalbe Static Encephalopathy
- 17 6/10/80 1,2,3 Down's Syndrome White
Cardiac Surgery
18 6/15/80 , Spastic Quadriparesis Hispanic
HerpesProfound Mental and
Developmental RetardationMicrocephaly .-
Obesity'Seizures
Visually ImpairedHearing Impaired
19 6/19/80 Chronic Encephalopathy Black/White
Motor Delays-SeizuresStrabismus
4,01.
20 9/4/80 1,2,3 Ccrebral Palsy Black -
Probable NeurofibromatosisSpastic Diplegia
Visua.11y Impaired -(questionable)
21 9/3/80 Down!s Syndrome,
Hispanic
,
...
White,(European and
South Ameritanparents)
,
r
Table 3
,t
,,
36
Child Date of Entry lears in Program Disability/Areas of Delay Ethnic Group
11/12/80 1,2,3 Premature' 22 White
,Cerebral Palsy .-
23 _5/13/81 2,3 Developmental Delay White,
Cortical BlindnessHypotonia
24 6/8/81 2,3 Congenital Arrested Hydrocephalus Samoan
Developmental DelayCongenital Bilateral Esotropia
25 6/16/81 2,3 Growth and Developmental Delay Hispanic
Questionable Ncrocephaly ,
Seizure Disorder
tr-
26 -6/24/81 2,3 Meconium Aspiration . White
Perinatal AsphyxiaGastrostbmy Tube %Seizure Disorder
)
27 9/11/81 2,3 Chronic Encephalopathy Korein
Seizure DisorderDevelopmental Delays
9/11/81 2,3 Severe Mental Retardation Black
Speech and Language DelaysMotor Delays
29 10/28/81 3 , Down's Syndrome Black/White
30 11/10/81 3 Sickle Cell Anemia Black
Pneumococcal Meningitis. Neurological Sequellae
31 12/11/81
32 1/27/82
33 2/10/82
34 2/10/82
35 3/11/82
36. 3/18/82
3 Down's Syndrome White
Congenital Heart Disease
3 Severe Developmental Delay Hispanic
Hearing Impaired (questionable)
3 Down's Syndrome Black
3 SIDS Black/Puerto Rican
Myaclonic Seizure
3 Down's Syndrome White
Congenital Heart Disease
3 Developmental Delay White
Severe HypotoniaFebrile Seizures
Table 30 7
Child Date of Ent61 Years in Program Disability/Areas-of Delay Ethnic Group
37 5/6/82 3 Moderate Global White
Developmental DelaySpastic Diplegia
38
"39
40
5/13/82'.
5/13/82
6/7/82
v
3 Down's Syndrome. White
3 Hydrocephalus Black
3 Microcephaly SHispanic,
Polybyoclonia .
"Sunset" Eyes with OpsoclOnusSeverely Delayed Development
41 7/1/82 3 Spastic Diplegia Black
..
1
,
/1
TABLE 4
st.
\.
as
'Table.4
Bayley Scales of Infant Development
Year 2
MENTAL SCALE
, Mean S.D. t value
.39
SignificanceLevel
Developmentd1,
Pre
15
.
,
90.7,
59.2
.
.
.
-5.82 p.
.
.0001
Post 131.0 74.7,
. 'Raw Score
,
Pre
15
.
, 72.2
.
37.8. ,
-4.59 p .0001
Post 95.2 42.6
PSYCHOMOTOR SCALE
!lean t valueSignificance
Level
DevelopmentalAge
.
Pre
15
i
83.7 52.1
-379 .002
Post 113.3 67.2.
\
Raw Score
.
Pre 33.5 14.3'
,
-4..71
.
.0001
Postir
14.
40.8i04
14.7
4"1
, .
.
. .
.
.
. ,
. Bayley.
. . .
.
. .
.
Table 4 (continued)
4
S.p.
.
.
t value
40
t
.
:.
SignificanceLevel
.
....
Scales of In'fant Development. .
Year, 3
MENTAL SCALE
N Mean
DevelopmentalAge
Pre
18,..
104..5
-3.81.
p .001
Post 143.7 103.9
Raw ScorePr;e
18
'.
80.7 45;9-4.74 p .0001
Post . 97.,7/ 48.8
.
1 .,
.
,,--
0:..
.
PSYCHOMOTOR SCALE
.
.
S.D.
.
t value
.
SignificanceLevel
..
N Mean
DevelopmentalAge
Pre
18
89.4..
59.10
p .001
Post.
.125.3 82.9
-4.17
Raw Score
Pre
-..
32.7 18.2
-4.72 p .0001
Post18
39.8 19.2.
I
, .. ,
. to
1. .
.
.)
.. . 4 8
......a......M....s.arare...............L.....
.
.
. .
4
TABLE 5
'
7
IL>
4.
41
t:4
o
.
.
'.
.
Uniform Performance
N
Table 5
.
42
System (UPAS)
.
.
nificanceS.D. t value
SigLevel
AsS.essment
Year 2
.
Mean
Number of Items
1
Pre,
16
42.6 28.5
-9.12
.
p .0001 .
...
PasSed (Total)
Post 64.2 35.9
Percentade of'Items.Passed(Total)
Pre 14.7 9.9-9.32 p .0001
-.Post 22.3 12.5
7-
.k.----
1
,
...,
.
N
.
Year 3.
.
.
SignificanceS.D. t value
LevelMean
Number of ItemsPassed (Total).
°Pre
18
46.2 31.3
-6.65 p .0001
Post 73.2 42.8
,
Percentage ofItems' Passed
P re
18
16.0 10.8
-6.62
,
,
p .0001
(Total)Post
.
25.5 14.9.
..
,
.
.
,
..-y. \.4.
.
.
.
.
Is
.
..
..
.
,
k? U .i
43
TABLE 6
5
Table 6
CurricUlum Objectives Checklist:
Year 2 .
Mean S.D. t value
`1
*
SlgniflcanceLevel
Number of ItemsPassed (Total
Pre
16
69.1, 141.6'
,
...
,-R..95
.
Post 107.1 52.3
Percenta, g of
'Items.Passed(Total)
Pre,
16
29.0. 17.6
-9.27
.
.0001.,
,
Post 44.8 21.9
Year 3
:Mean S.D. t valueSignificance
Leyel
.
Number of ItemsPassed (Total).
Pre
18
91.5 55:3
-5.09 .0001
.
Post 136.0 78.2
Percentage ofItems Passed(fotal)
Pre A
18
32.5 17.7,
-5137
-.
p
0t
.0001
,Post 48.2
.
24.5
,
5)
.?
*.
.00
TABLE 7
53
, 45 '
Cs.
Table 7
Parent Behavior Progression Scale
Year 2
Mean . .S.D. tvaluè
Total Raw= Score"
Pre
Post
16
47.7 12.2
54.3
Year 3
10.2
-3.90
4
46
SignificAnce.'Level
. ,
p
Mean S.D. t value_Significance
. Level4410.1
Total RawScore
Pre
Post
17
54.1
58.8 . 12.0
5 1
-3.05 p .Q08
.... I
'41
TABLE 8
47
=
4
Table 8Year 2
PARENT REACTION QUESTIONNAIRE
(Adapted from Project KIDS.Dallas; Texas)
The San Francisco Infant Program wants to give you 6nd your child thebest possible program. Your answers to these quest.ions will help us to
. strengthen and improve the program.
Please answer each question by placing an "X" in'the space that bestfits how you feel. An example would be:
.
1) Is your child enrolled in theSan Francisco Infant Program?
48
1 YesI think
soI don'tknow
I don'tthink so
( ) ( ) ( ) ( ) (-)
Please feel free to write in any additional comments and cTg'rify anY answersyou need to.
1) Is the Infant Program staffqualified to work with yourchild?
2) Is there good communicationbetween you and the projectstaff?
3) Is the teacher and therpaisthelpful in explaining how.todo the educational program?
4) Do you feel that you are animportant participant in theprogram?
5) Has the program helped you tobetter understand your child'sabilities and needs?
6) Has the Infant Program helpedyou to learn more about working'with your child?
7) Are the educational programswritten to meet the individualneeds of your child?
YesI think
so
I on'tknow
I don'tthink so
,
10/11
(91%)
9/11 2/11
(82%) (18%)
10/11
(91%)
3/11 3/11
(73%) (27%)
11/11
(100%)
11/11
(100%)
9/11 1/11 1/11
(82%) (9%) (9%)
5
Table 8Year 2
Parent Reaction QuestionnairePage Two
8) Are the toys useful in doingthe educational program'activities?
9) Can you easily understand thedirections for the educationalprogram?
10) Did you feel that the therapistand teacher took too much timedoing your child's evaluation?
'11) Did you get a completeexplanation of your child'sevaluation?
-.. 12) Did you understand what you weretold about the evaluation?
13) Did you agree with theevaluation results?
14) Are you happy with the SanFrancisco Infant Program?
15) Do you feel that charting (data-taking) is important?
16) Are the charting instructionseasy to follow?
17) Do you feel that your childhas made progress in theInfant Program?
18) Do you want to continue inthe program?
19) Would you like to become moreinvolved in the program?
* 1/11 No Answer
(9%)
49
YesI thinkl
so
I don'tknow
I don'tthink No
,
so
1/11
(9%)
3/11
(27%)
7/11
(64%)
6/11 4/11 1/11
(55%) (36%) (9%)
9/11 2/11
(82%) (18%)
7/11 2/11 2/11
(64%) (18%) (18%) ,
10/11 1/11
(91%) (9%)
7/11 3/11 1/11
(64%) (27%) (9%)
7/11 2/11 1/11 1/11
(64%) (18%) (9%) (9%)
11/11
(100%)
10/11 1/11
(91%) (9%),
4/11 2/11 2/11 2/11'
(371) (18%) (18%) (18%)
Table 8Year 2
Parent Reaction QuestionnairePage Three
20) Has the San Francisco InfantProgram helped other membersof the family understand thechild's needs and abilities?
21)- Do you feel siblings should beincluded in the program in someway? * 1/11 No Answer
(9%)22) Do you feel the integration of
min-disabled children in theprogram has been beneficial?
50
YesI thinkso
I don'tknow
I don'tthink so
No
7/11 3/11 1/11
(64%) (27%) (9%)
5/11 1/11 2/11 2/11
(46%) (9%) (18%) (i8%)
9/11 1/11 1/11,
(82%) (9%) . (9%)
. 51.
1,
,
4
TABLE 9
*
,
e
,
,
,
go'
Table,9Year 3
PARENT REACTION QUESTIONNAIRE
(Adapted from Project KIDS Dallas, Texas)
The San Francisco Infant Program wants io give you and your child thebest possible program. Your answers to these questions will help us-tostrengthen and,improve-the program.
Please answer each question by 'placing an "X':in the space that bestfits how you feel. An example would be:
.1) Is your child enrolled in theSan Francisco Infant Program?
52
YesI think
so
I don'tknow il
!,44
I don'tthink so
INo
(X) ( ) ( ) (
Please feel free to write in any additional comments and clarify anY answersyou need to.
1) Is the Infant Program staffqualified to work with yourchild?
2) Is there good communicationbetween you and the projectstaff?
( )
YesI think
so
I don'tknow
I don'tthink so
No
17/17100%
17/17
3) Is the teacher and therpaist , 17/17helpful in explaining how to 100%
do the educational program?
4). Do you feel that yo.0 are an 16/17 1/17
important participant in the 94%
program? .
5) Has the program helPed you to 16/17 1/17better understand your child's 94% 61,
abilities and needs?
6) Has the Infant Program helpedyou to learn more about workingwith your child?
17/17100%
7) Are the educational programs 16/17 1/17written to meet the individual 94% 6%needs of your child?
(50
Pai-ent Reaction QuestionnairePage.Two
No Answer
Table 9 .
Year 3
8) Are the toys useful in doing.the educational program
/activitis?*1/17
9) Can you easily understand thedirections for the educationalprogram?
10) Did you feel that the therapistand teacher took too much timedoing your child's evaluation?
11) Did you get a completeexplanation of your child'sevaluation? *1/17
6%
12) Did you understand what you were: told about the evaluation?
13) Did you agree with theevaluation results?
14) Are you happy with the SanFrancisco Infant Program?
15) Do you feel that charting (datataking) is important?
16) Are the charting instructionseasy to follow? *1/17 . .
17) Do you feel that your childhas made progress in theInfant Program?
18) Do you want to continue inthe program?
19) Would,you like to become moreinvolved in the program? .
53
Y.er think
soI don'tknow
I don'tthink so .
No
15/1788%
1/176%
16/1794%
1/176%
12/17 1/17 1/17 1/17 2/17
70% 0% 0% 0% 12%
14/17 1/17 t 1/1782%
,...
16/17 1/17
94% 0%
e16/17 1/17
94% 6%
17/17100%
14/17 1/17 2/1782% 0% 12%
13/17 1/17.
1/17'' 1/17
70%
17/1710Q%
16/17 t 1/17
94% 6%
17/171 00%
,
. Parent Reaction QuestionnairePage Three
-.
Table 9'Year 3
tr>....,...
20) Has the San Francisco InfantProgram helped other membersof the family understand thechild's needs and abilities?
21) Do you feel siblings stould beincluded in the program in someway? *2/17
12%
22) Do you feel the integration of
. non-disabled children in theprogram has been beneficial?
*3/17la% ,
r-
1
\ .54
YesI think
soI don'tknow
,
I don'tWnk so `NC)
-
10/17 6/17 111759% . 35% .60
,
10/17 V17 2/17 1/1758% 1ZZ' 12% 6%
12/17 1/17 1/1770%
,
t
. ,.
,
4
,
Table 10
DeVoss Infant Program (San Jose)
UPAS Data
Pre- (January, 1981) & POstest (July, 1981) Comparisons
-Percentage of Items Passed
56,
,CHILD PRE-ACADEMIC GROSS MOTOR
"
COMMUNICATION SOCJAL/SELF-HELP
.
Pre (1/81)
Post (7/81)
13%
18%
53%
73%
16%
30%
11%,
27%
.
..:
.
...
Pre (1/81)
Post (7/81)
18%
8%
36%
48%
14%
, 29%
22%
33%
.
-,
Pre (1/81)
PoSt (7/81)
.
13%
16% .
34% .
53%
4%
6i
20%
20%
Pre (1/81)
post (7/81)
36%
50%
'59%
70%
46%
60%
44%
64%
Pre (1/81)
Post (7/8))
.
26%
53%
48%
61%.
14%
29%
40%
44%.
.
Pre (1/81)
Post (7/81).
7%
'16%
12%
18%.
13%
25%
7%
22%
Pre (2/81)
Post (7181)
26%
37%
33%
36%
38%
56%
22%
47%
,
8
Pre (2/81)
Postj(7/81)
14%
16%
20%
21%6 3
7%
9%
9%
13%
1
1
J
. .4
. .Table 11
.
.
58
. ,
DeVoss Infant Programi (San Jose) ,
Curriculum Checklist Data
*.Pretest (January, 1981 & Postest (July, 1981) Comparisons
Number & Percentage of Items Passed -
.
.
. . .
,
CHILD COMMUNICATION GROSS MOTOR FINE.MOTOR COGNITION PRE-ACADEMIC
.
, .
. .
..
.
Pre 7/28 (25%) 43/73 (59%) 29/51 (57%) 13/30J43%) 0/46 (0%)
Post 15/28.(54%) 43/73 (59%) 49/51 (96%) 19/30 (63%) 0/46 (OW
Pre 6/28 (21%) . 41/73 (56%) 38/51 (75%) 24/30 (80%) -0/46 (0%)
Post 15/28 (54%)' 49/73 (67%) 41/51 (80%) 24/30 (80%) 1/46'(2%)
-.2/28 (7%) 42/73 (58%) 14/51 (27%) '11/30 (37%) 0/46 (0%)
Post 6/28 (21%) 52/73 (71%) 26/51 (51%) 19/30 (63%) 0/46 (0%)
,
.
,
,
Pre 19/28 (68%) 52/73 (71%) 48/51 (94%) 25/30 (83%) 13/46 (28%)
.Post 24/28 (86%) 55/73 (75%) 49/51 (96%) 30/30 (100%) 34/46 (74%)
-
.
.
.
Pre 8/28 (29%) 43/73 (59%) 43/51 (84%) .25/30 (83%) 0/46.(0%);
Post 11128 (39%) 54/73 (74%) 48/51 (94%) 30/30 (100%) 5/46 (11%)
Pre 6/28 (21%) 10/73 (14%) 17/51 '(33%) ' 7/30 (23%), 0/ 6'(0%)
Post 14/28 (50%) T8/73 (25%) 35/51 (69%) 20/30 (66%) 6 (0%)
,
Pre 20/28 (71%) 26/73 (36%) 44/51 (86%) 21/30 (70%) 3/46 (7%)
Post 24/28 (86%) 39/73 (53%) 49/51 (96%) 30/30 (100%) 13/46 (28%
1
Pre. 0/28 (0%) .
615/73/21%) 37/51 (73%) 14/30 (46%) 0/46 (0%)
7/28 (25;) 22/73 (30%) 39/51 (76%) 15/30 (50%). .0/46 (0%)
_Post H,
Table 12
DeVOss Infant Program (Sin Jose)
UPAS Data
Pretest (December, 1981) & Postest (June, 1982) Comparisons
Percentage of Items Passed
60
CHILD PRE-ACADEMIC GROSS MOTOR COMMUNICATION SOCIAL/SELF-HELP
1
Pre (1/81)
Post (6/82)
13% 9%
29% 31%
2
Pre (12/81)
Post (6/82)
12%
6% 8%
33% 3'8%
23% 57%
3
Png (12/81)
Post (6/82)
15%
4Pre (12/81)
Post (6/82)
5Pre (12/81)
Post (6/82)
6%
36%
4%
22%
47%
51%
5% 16%
14% 18%
7% 11%
28% 27%
7%.
12%
6
Pre (12/81)
Post.(6/82)
16% .
45%
7
Pre (12/81)
Post (6/82)
5%
14% 28%
16%
32%
4%
9%
4%
20%
59%
64%
35%
55%
24%
62%
10% 21%
39% 63%
8Pre (12/81)
Post (6/82)
11%
37%
4%
36% 52%
29%
61%
11%
38%
10%
46%
Table 1352
DeVoss Infant Program (San jose)
Curriculum Checklist Data
Pretest (December, 1981) & Postest (June,I1982) Comparisons
Number N Percentage of Items Passed
CHILDSOCIAL/
SELF-HELPCOMMUNICATION GROSS MOTOR FINE MOTOR COGNITION
PRE-ACADEMIC
Pre
st
26/60
42/60
(43%)
(70%)
3/30
15/30
(10%)
(50%)
70/ 1 l\j.22/52
80/112
)3
(71M 46/52
(42%)
(88%)
16/30.(53%)
26/30 (87%)
2/45
.3/45
(4%)
(7%)
2
Preu
Ppst
20/60
30/60
.b
(33%),
(50%)
10/30
23/30
(33%)
(77%)
73/112
75/112
(65%)
(67%),
31/52
39/52
(60%)
(75%)
20/30
28/30
(67%)
(93%)
1/45
10/45
(2%)
(22%)
3
Pre
Post ..17/60
14/60 (23%)
(28%)
2/30
3/30
,
(7%)
(10%)
61/112-
71/112
(54%)
(63%)
21/52
25/52
(40%)
(48%)
1/30
1/30
(3%)
(3%)
0/45 (On
1/45 (2%)
4
Pre
Post
20/60'
27/60
(33%)-
(45%)
2/30
8/30
(7%)
(27%)
62/112
73/112
(55%)
(65%)
d
20/52
39/52
(38%)
(75%)
13130
17/30
(43%)
(57%)
0/45
5/45
(0%)
(11%)
5
Pre
Post
18/60
22/60
(30%)
(37%)
2/30
5/30
(7%)
(17%)
76/112
80/112
(68%)
(71%)
22/52
34/52
(42%)
(65%)
5/30
11/30
(17%)
(37%)
1/45
2/45
(2%)
(4%)
6
Pre
Post
39/60
56/60
(65%)
(93%)
20/30
25/30
(67%)
(83%)
68/112
73/112
(61%)
(65%)
38/52
,45/52
(73%)
(87%)
27/30 (96%)
30/30 (lpo%)
6/45
30/45
(13%)
(67%
7
Pre
Post
37/60
54/60
(62%)
(90%)
5/30
17/30
(17%)
(57%)
69/112
74/112
(62%)
(66%)
38/52
49/52
(73%)
(94%)
25/30
28/30
(83%)
(93%)
3/45
29/45
(7%)
(64%
8
Pre
Post
29/60
52/60
(48%)
(81%)
7/30
19/30
,
(23%)
(63%)
66/112
71/112
(59%)
(63%)
6f
37/52
49/52
(71%)
(94%)
19/36
29/30
(63%)
(97%)
3/45-(7%)
28/45 (62%
..
..
A
FIGURESI - 8
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LIFTING ARIVI8
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ROLLING
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DAYS
Figu re 1
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a
CgoiSkto-t-q__LPRome)3. Roiling Turnmy to Back
Objective:
Hanson, D.S.
p. 78
Materials:
9.
-
roils fromstomach to back
Child will roll from stomach to back withoutassistance within one minute when placed on thefloor with favorite Object out of reach,for 80% ofthe trials on 2 out of .3 consecutive days.
Wheo rollino.child should demonstrate truni:. rotation
by leading With either an arm or ieg and allowing therest of the body to follow in sequence...
Favorite toysPerson's face and/or voiceBlanketLarge wedge
Prerequisite: None
Procedures: 1. Position - Lying on tummy (alternative - sidelying)
Carolina
Area: M-P
17, dp. 241
HELPNo. 3.10p. 75
2. Teaching Procedures:1
I) Entice the child to roll by dangling a toyin front of his face, then moving it to theside and behind his line of sight.
2) Place the child on a blanket and tilt himslightly, making it easier for him, to roll.
3) Place the child on a large wedge and introducethe rolling pattern by turning his head orshoulder and guiding him through the movement.After a few repetitions, place the child backon the floor or blanket and try to secure amore active roll on the part of the child.
Alternative may begin in sidelying:
I) Lay the child on his side periodically to playwith a toy. Remove the toy and show the childhow to return to his back by gently movingback his snoulder or hip. Place a small pillowor towel next to the child's back to help himstay in a side-lyin position.
2) Move a toy or mobile across the child's line ofvision and then over his head. Encourage thechild to follow the toy until he rolls ever.Be sure the child rolls to both sides wheneverdcing this activity.
63
HELPNo. 3.10p. 75
HELPNo. 3.17p. 77
3) Place the child inside a large carpetedcylinder in side-lying position. Move the
cylinder slightly to start the rollingmovement to supine.
4) Place the child in side-lying oft a towel.Lift one edge of the towel to start therolling movement to supine.
5) Roll by using the shoulder to lead. One
arm should be up over the child's head. Pull
the opposite shoulder back. The child will
assist by moving his head, trunk, and legs .
when 1-,e feels his arm moving. Repeat, using
the other arm and helping the child roll tothe opposite side.
6) Roll by using the leg to lead. Bend one hip
and one knee up; the other is held straight.Gently turn the bent leg to the opposite -
side,of the body. The child's trunk, arms,
and head should follow. Repeat using the
other leg.
8,1-4
10.
Steps: 1. Child prompted through 3/4 of roll. Flex
hip and knee (be sure bottom arm is outfrom tindvr child) move child pist sidelying.Childliels last 1/4 of roll independentlywhen presented with a favoHte object offto the side.
Hanson, D.S. 2. Child prompted through 1/2 of roll. Move child
p. 79 to sidelying with flexed hip and knee. Child
rolls last 1/2 of roll independently whenpresented with a favorite object off the side.
3. Child prompted through 1/4 of roll. Flex htp
and knee. Child rolis 3/4 of roll independentlywhen presented with a favorite object off to theside.
4. Child rolls from stomach to back With only aslight prompt of nudge to begin roll whenpresented with a favoilte object off to the side.
5. Child independently rolls from stomach toback when presented with a favorite object off
to the sid,-
Criterion:
When your child gets 80% of the trials correct,'on 2 out off3 consecutive days, move on to the next step.
Child will roll from stomach to back without assistancewithin one minute when placed on the floor withfavorite object out of reach for 80% of the trials
on 2 out of 3 consecutive days.
11.
12.
Observati1T Does your baby lead more with.her arm or leg?Can your baby stay in a sidelying position independently?Howlong? What order does your baby's head, arm, chest,hips and legs roll?
4
PrecauVon:Carolina
p. 241
If the child is spastic, it is important to guardagainst mass thrusting movements in the rollingpattern. Make sure the child is relaxed and dothe movements slowly. Allow time for the child torespond and reward him with praise, clapping, etc.if movement iii5eFTF;FITied well.
Do not use this exercise if the child arches hisback, head and legs during the roll.
HELPNo 3.17 Position the child's arm out of the way, eitherp.77 straight up overhead or down by the side, on the side
toward which he is moving.*
*This is to protect the child's shoulder.
Hanson, DSpp. 70-71#6
Objective:
Material:
Prerequisite:
Procedure:
Hanson, DS70-71
#5
HELPNo. 3.51p. 86
r.P., ,
. t
. .
A 'ail WO,.(
,
, 3
AL. ,,,V.J. A .4.
6. SITS, NO SUPPORT
Child will sit independently with no support, headand back straight, for one minute when placed ina sitting position on a firm surface, for 80% ofthe trials on 2 out of 3 consecutive days.
Favorite Toys2-hnded musical instrumentsLarge lightweight objects - require 2 hauds; i.e.,
balloon, dollBusy Box
Sits Self-Supported by Arms and Hands
1. Position - Place child in sitting positionsupported by arms and hands on a firm surface.
2. Teaching Procedures:
Using the following procedures to encourage freeingup of the hands ip sitting.
1) Play'ball with the child while she sitsunsupported.
2) Place the child in sittihg. Let the childplay with a Busy Box hung on the wall ather level.
3) Let the child hold large objects which requiretwo hands, e.g., a large ball, balloon or doll.
4) Hold a tby overhead so the child must reachup with her arms.
5) Play pat-a-cake. .
6) Let-the child play twb-handed musicalinstruments,- e.g., a tambourine, triangleor rhythm sticks.
21.
HELPNo. 3.51p. 86
7) Let the child sit on a small box with herfeet supported on the floor. Do any of
the above ictivities.8) Let the child sit astride a narrow seat
with her feet on the floor andiegsapart. Let her look at books or identifybody parts in a mirror. .
9) Encourage the child to kgpiher back' straight in sitting by u ing one or more
of the following activities:a) Tap and rub the base of the spine.b) Bounce the child gently in the
sitting position.c) Tap the shoulders back.
.,
\
8d
,
,
22.-
,
!
-.
Steps-
Hanson, DSpp. 70-71#6
Criterion:
1. Child will sit self-supported with hands onknees, legs slightly apart to provide a stable
sitting base.
(a) Child sits as specified for 10 seconds.20 seconds.30 seconds.
40 seconds.
50 ieconds.60 seconds.
2. Child will sit self-,supported with one handon knee,-the other free to reach or play with
objects. (Present a toy to encourage one
hand to be free).(a) Child sits as specified for 10 seconds.
20 seconds.
30 seconds.
40 seconds.50 seconds.60 seconds.
3. Child will sit independently with head andback straight when placed in at sitting .
position. (Hands free.)
(a) Child sits as specified for 10 seconds.20 seconds.30 seconds.40 seconds.50 seconds.60 seconds.
When child does 80% of the trials correctly on 2 out
of 3 consecutive days, move to next step.
Child will sit independently witti no support, head
and back straight, for one minute when placed in
a sitting position on a firm surface for 80% of the
trials on 2 out of 3 consecutive days.
23.
Observation:
Precaution:
Does your child startle easily? Does s/he fall
over from sitting when there are loud noises or
sudden movements? Can your child look freely.in
all directions while sitting?
If you child,arches or pushes backwards while
in this position, rock him/her at shoulders side
to side and bring shoulder blades gently dOwn
and forward; (may also need to press down with
a flat hand on the center of their upper chest
to bring head forward). If you have problemscontrolling this, consult your therapist.
4
13
SEL F -A-LP
5. Scoops food, feeds self with spoon.
Objective: A) When a spoon with food is placed in child's handchild will bring spoon.to his/her mouth, take the foodoff the spoon within 2 minutes of presentation of spoon;for 80% of the trials, on 2 out of 3 consecutive days.
B) When spoon is placed'in tray/bowl, child will pick upspoon, scoop food from bowl, and feed him/herself 1 spoon-ful of food within 2 minutes of presentation of spoon,for 80% of the trials, on 2 out of 3 consecutive days.
Material:
Procedure:
HELPNo. 6.26(3)p. 164
Hanson, D.S.p. 180
Child-sized spoon, anY spoon-foods.
1. Position child in an upright'pnsition so that his/herarms/hands can move freely.
2. Place the spoon in the child's hand or guide his handto the spoon and assist his grasp if he cannot hold ontothe spoon. If ne Shows hand preference, place the spoonin that hand.
3. Help child to pring spoon up to position as stated inobjective.
4. May place spoon.in child's hand and take him/her throughthe steps, requiring him/her to do only what is stated inobjectives, 'e.g., show him/her how to pick up spoon, scoopand bring spoon partway to mouth.
5. If child succeeds at objective, praise ihild, mark (+)
6., If child does not complete objective, assist him/her.Give him/ner only as mucn assistance as is necessary.Mark (-).
7. As you teach feeding, teach a particular step until the
child is doing it independently, then move to the nextstep and teach it tO independence and so on. Never go
back and prompt your child when the child can already
do something independently. For example, prompt the
child to scoop the food as necessary, and then let .111.\,Let the child perform bringing the spoon to the mouth -..
and removing the food independently as you have already
taught her/him to do- On steps you have not yet taught,
completely guide the child through that step,. For
instance, if you have not reached Step 82 y t, merelyguide the child-through it --but do not vide thatguidance for steps you have tra
8. If child gets 80% of the trials correct, on 2 out of3 consecutive days, go on to the next step.
9
Steps:
14
A. 1. When a spoon is placed in child's hand, child will mainiain
his/her grasp on spoon for at least 30 seconds. (Spoon may
or may/not contain food)
2. When a spoon with f)od is placed in child's hand, and childis assisted in bringing spoon to mo , c d will place
spoon in mouth and take the food off the spo , within 1
minute of presentation of spoon.
3. When a spoon with food is placed in child's hanchild is assisted in bringing spoom to:
a) 1" from child's, mouthb) 6" "
II
0 1 fi. "It
child will bring spoon the rest of the way, place spoonin his/her mouth and take the food off the spoon, within',1 minute of presentation of spoon.
B. 1. When a spoon with food is placed in tray/bowl, child willpick up spoon, scoop food from bowl, and feed him/herself
1 spoonful of food within 2 minutes of presentationof spoon.
2 When spoon is placed on tray/bowl, child will pick up spoon,scoop food from bowl, and feed him/herself 1 sPoonful of'food within 2 minutes of presentation of spoon.
For each of the above steps, use the following prompts, if necessary:a) maximum prompt, i.e., assist child through most
of action.b) moderate prompt, i.e., assist child through
initial part of action.c) mimimum prompt - i.e., tap child,'s hand in
-direction of mouth/spoon.d). no prompt.
Criterion: A) When a spoon with food i placed in child's hand child willbring spoon to his/her mouth, take the food off the spoonwithin 2 minutes of presentation of spoon, for 80% of thetrials, on 2 out .of 3 consecutive days.
B) Whmspoon is placed on tray/bowl, child will pick upspoon, sco,p food from bowl, and feed him/herself 1 spoon-
ful of food within 2 minutes of presentation of spoon,for 80%.of the trials, on 2 out of 3 consecutive days.
Suggestions:
1A. To Teach ChiA to hold spoon:
15
1. Acquaint the child with a spoon. Let him look at at,
- touch it, grEsp it and handle it. Let him do this.as
yop feed him with another spoon, if this does not greatlyinterfere with his feedtng.
2. Place the spoon on the ,table, let him reach and grasp fOrHELP it, allowing him to use whichever.hand he prefers. AtNo. 46.26(1,3-5) first, he may not use the spoon instead, he.may experimentp. 164 with it by banging and waving it.
3. Offer 'a small wooden mixing spoon, a large serving spoon,or measuring spoons"during play.
4. For the older delayed child:a. Offer a spoon with a built-up handle if the child's
grasp is weak and he.has difficult, grasping a regularspoon. . Wrap 'a layer of sponge around the spoon handlewith masking tape to build up the handle or use acommercially made built-up.h
,b. Place an elastic cuff aroundInsert a spoon handle intassist the child who imaintaining grasp.*
dle spoon.the palm of the Vend.e cuff. This will
hysically incapable of
B. To teach child to bring'spo to mouth:
1. Let the child grasp t e spoon with either hand. ..Do notinsist he use the r'.ht or left hand exclusively unless heshows a strong h. preference or he definitely has betteruse of one hand more than the other.
2. Sit next to the child in front or behind him when assistinghim. ,D0 not sta,nd over him.
3. Scoop a favorite food or a food which will stick to thespoon. Encourage the child to bring the spoon to hismouth to lick it.,
4. Assist or guide the child in bringing the spoon to hismouth, if necess4ry.
5. Continue to allow the child to finger feed while he islearning .o holp and use the spoon.
6. Use a spoon which will meet the child's needs:. a. Use a child's spoon. Be sure it is not too large
for the child's mouth or hand.b. Use a spoon with a shallow bowl if the child htis
difficulty removing the food from the spoon wfth hisupper lip.
.c. Use a teflon coated spoon for the child who has astrong bite reflex. Do not use a plastic spoon sinceit may break.
d. Use a child's spoon in which the bowl of the spoonturns toward the child. With this type of spoon thechild need not turn his hand to bring the spoon tohis mouth. Commercially made spoon of this type are
sold at drug stores.
HEL
No. 6.31(2-7)p. 165
16
C. To teach child to scoop food; feed self with spoon:
1. Let the child experiment and practice self feeding witha'spoon. Do not scold or fuss about spills or messiness.Spread newspapers, an old sheet, or a plasti^. sheet on thefloor to catch spills. Make mealtimes as pleasant aspossible and do not pretsure the child to feed himselfcompletely.
2. Help the child take over before he becomes frustrated inhis efforts to feed himself. Be sure to give the childthe opportunity to do as much as possible by himsl.lf.
3. Allow the child to finger feed when he gives up the spoonduring the meal:.
4. Assist and guide the child as necessary in inserting the spooninto the dish, scooping and bringing it to his mouth. Hemight remove the spoon from his mouth by tipping it upward.Mother should become less available, but still remainnearby as the child learns to be more independent.
5. Let the child practice at the beginning of the meal whenhe is hungriest.
6. Use a bowl with a high edge or a "scoop plate"'with ahigh curved edge on one side. Position the scoop plateso the higher edge is on the side toward which he isscooping.
7. Let the child use a bowl with a non-slip bdttom or suctioncup which will prevent the bowl from skidding around whilechild is trying to scoop the food.
8. Serve lbods which are easy to handle with a spoon. Thinsoups and rolling peas are difficult for beginners. Foodswhich will stick to the spoon will make scooping andretaining food on the spoon easier. Some food suggestions:Stews with mashed or chopped meats, vegetables; stews withMashed or chopped meats, vegetables. Casserole or creameddishes using hamburger, meats, poultry, pork, fish, veg-etables which are chopped or thinly sliced. Rice may beadded to make it stickier; vegetables which are mashed,chopped; macaroni and cheese; spaghetti (short noodles);cooked cereal; soft rice with chopped meats, vege\:ables;
94
17,
Spanish rice; junior or toddler foods; mashed pumpkin,squash, sweet potato; pudding; custard; poi; creamcheese; yogurt; cottage cheese; fruit sauces; icecream.
9. Let the child practice scooping by:a. Scooping wet or dry sand with a large spoon, wooden
spoon, or small spoon.b. Scooping soan suds, shaving cream from a pan or
bowl with a large or small spoon.c. Scooping uncooked macaroni or rice in a large box
with a large spoon.
.33
CoAktourcA--ri DIV
5. Makes Sounds For Certain Objects
Ob ective: Child will consistently use one sound to identify or requestjot' one particular object or person within 20 seconds ofobject/person presentatiOn, for 80% of the trial's, on 2 wit
of 3 consecutive days for a total of at least 3 objects/persons.
Materials: Favorite toys
- Procedure:1 A. Encourage child to vocalize for a,toy.
Carolina14h
p. 209
.,
1. Using a toy the child is interested in, e.g,'a ball,the caregiver will start the inferaction with "here is.
the ball" and giving it to the thild.-*
2. Give the.child a few seconds to play with the object, ,'
then ask for the Child to return it "give me the ball4
in a friendly-tone of voice. '
3. After two or three exchanges with the caretaker voca)-
izing each time, askIthg'child "do ybu want lie'bal)?"
and wait for the child to make a vocajization.
4. Return the toy imeediately updn,the onset ofan.vocal-
ization on the part of the baby except crying.
B. Encourage child to use specific sounds to identify specific,
objects.
Hanson, DSp: 151
1. Present an.object and label the object. Chjld repeats.,
sound. Example: Parent shows child a ball.
Parent says, "Ball."Child sAys, "Ba."Parent says, "That's right, ball."
2. If child does not respond correctly, repeat, "This is
a ball. Say ball."
3. Present objects for which the child already knows the'
'sound. Example:(b) for bottle or ball or bye
(m) for mommy(w) for water(d) for daddy, drink
4. When you know the child can almost always say the sound
for the object, require the child to say the sound to
request an object or activity. Example: Child must
say "d" before being let down.
5. Also pair sounds with different activities. Example:
"choo-choo" with train"p,p" with popbeads"grrr" with tiger puppet"varoom" with toy car.
6. Praise child for repeating sound or initiating sound
as case may be.
96
.o
Hanson, DS ,
p. 151
34
7. Keep a record of the sounds that your child pairs'with certain objects.
8. *Tell family members and friends what sounds thechild makes and ask them to require the child tomake these sounds before gettina Ihe object or,activity.
9. 'Be consistent. Once the child learns to make-thesound, require that s/he sa'y it all the time.
10. If child makes correct sound witgin 20 seconds ofobject presentation, mark (+). If child does not
vocalize or,produces incorrect response, mark(-).
. Repeat correct sound to child and encourage nim/her
to imitate you. If child imitates and gives correct
sound, give child object. Wait for appropriate time
to start another trial.
11. .If.child gets 80% of the trials corri,ct, pick another object.
C. Encouage child to Lise specific sounds to identify specific
people.
HELPNo. 2.29(1-4)p. 56
1. Make sure you name yourself "Da-da," or "Daddy,"
"Ma-ma" or "Mommy" when,you greet the child, when youpick the child up or when you call hith.
2. Reward the childts.correct use of a name, if heusually calls both parents, or'all people "Dada." Use
the name of the otherpareQt and/or people to helpthe child understand that each name is for a specific
person'.
3. Respond quickly when you are correctly named. Give
the child lots of praise for being coi-rect!4.. Show the child pictures of familiar people. Label the
pictures. Encourage the child to.point to whom you
name and to say the names. Use large clear pictures
the child can touch.
1 ,
Hanson,:DS. more cookie .down
p. 152.
potty. .book up .
1drink go mama/dada
5. After child produces cOrrect sound, repeat the correct
label (eg. "ball", "bottle") back to the child so that
he/she, hears the correct label..
. N
k
O. Encourage child toiuse his spetific sounds to request
specific objects..t-
4 1. After child learns to consistently use a specific
sound for a specifit object, encourage child to
-request for'theobject.2. %Child may indicate request by'gesturing toward obiect.
,Ask child "What do You want?" .If child continues
aesturina; label the object, and encourage child tg,,
request for the object uSinagthe sbund that he/she'
consistently uses for'that object. If necessary,
produce the first sounds of the word and encourage
the child to imttate the correct response. (see step B)
-p 3. If child sOontaneously uses a sound to request for an
objeci,.make sure you respond by giving him the object,
'if pOssible.
4 S,uggestioriS-for request words:
SuggeStions:
a
1. Do not be conceiiied or worried if the child's words are
difficult to understand. You can probabW recognize'the
words by context.
2. Do not correct the child directy. Proifide a gbod model
for the word phrase lhat s beim, mispronounced, e.g.,
.
if the infants says "poon" for "spoon" Say, "That's.
HtLP right, that's a spoon," .
No. 2.33(1-4)p. 57 3. Continue to talk to the child by naming-obieets in his
environment, by. describina,his activities ahdour
activitiqs.
4 'Do not yield to the temptation to say the vidrd the way
the child does, even if it sounds cute. The child thinks
'he is saying it correctly-and may be confused if ,epti mis-
, pronounce tke word.
9d
(7,
A
,
. Criterion: Child will consistently ue one sound to identify or1444111, request for.one particurar'oblect/person, within 20
seconds of object/person presentation, for 80% of thetrials, on 2 out of 3"FoAsecutive days, for a'total ofat least 3 objects/person.
A
36 *
,
Nr.
e_OGMITIVE:
,t
57.
.1. Imi4tes Familiar GeSture
Objective:
Materials:'
.procedure*:
Hanson, DS
P.,159
Child Will make the .same:gescure within 20 peconds
of adult modeling a gesture from child's repertoire
for at least 5 familiar gestures for 80/of the
trials on 2.1Cut of 3 consecutive days.
Toys/objects.that the 'child is familiar with
1. Place child in comfortable position so that
his/hen hands are.free to move.
2. Observe child in play and.the behaviors he/she ,
spontaneously performs. Choose one of these 1
actUms, accorling to the step child is ,
working on.
3. .Make the action a couple Of times then give
cue,"Do this, (child's name)" Repeat 2-3
times. Give child 20 seconds to respond-z.
4. If'he/she produces the required response within
20 seconds, mark (+). Praise child.
5. If child does not respond,correctly within 20
seconds, mark (-). 'Then go through tlie
correction procedure.
6. Correction Procedure: Go through step 3 of
Procedure again. If child does not respond to,
the prompt heMhe is working on, give him/her
more help (go back to previous prompt). If
child responds correct1Y, ,PraiSe child, Do not
use these corrections as trials.
7. If child gets 80% af the trials correct on 2. .
out of 3 6nsecutive days, go on to next step.
8. Important: Teach activities only under appro-,
priate conditions. For example, don't.
encourage,blowing "raspberries" during dinner
or banging the feeding spoon on the table:
oollr
3
Steps:
Criterion:
58.
Child will make the s'ame gesture withini. 20 seconds ,a
of adult modeling:1. A gesture/action involving an object, from
child's repertoire(eg. banging 2 objects-
together, shaking 'objvt) A2._ A gesturel body action, not involving objectS,,'
from child's repetoire (eg. clap hands, tapknees.)
For each of above steps, go through the followtng. prompts, depending on child's movement patterns:
a) maximum prompt Oe. prompt at elbows or., shoulders through most of action)
b) moderate prompt.(ie. prompt at wrist, throughinitial part of,action)
c) mirlimuw prompt (ie. tap at wrist or hand)
d) no
Child will make the'same geSture within 20 secondsof adult modeling a gesture from child's.repertoire, for at least 5 familiar...gestures, for80%-of the trials-on2-out of-3-conseout4ve days.
10i
4
-1
H ELP
No. 1.42 (1)p. 16
Hanson, DSp..158
I,
1. Observe the motor behaviors the child qhowsspontaneous-IS, toward objects or toys.. At this
time, they'are behavtors such as banging anobject on-the table, wavi6g an Object,.etc.When the child is*not engrosspd,in any activity,perform thls familiar action in front of him andthen tee tf,he makes any movement in.responseto you 'o'r imitates the bahavior.performed.
2. Choose.behavors that will be easy for the childto perform. Vsersome behaviors hat include amobject (examples: pound drum, knock overblocks, stack blocks; roll ball, shake rattle,'ring bell, pat table, blow feather) and other'behayiors without objects (examples:
.
pat-a-cake, wave bye-bye, open mouth, kisiing,movements, raise arm, 'itsy-bitsy spider,""so big" (child puts hands up to show "so big"),tongue clickS, cough).
A
'
0,1
1
4C4
V-1 A1E1 Moro R...(0a)-e-cl- .M6-sUt
8: Transferi Objectlb
20
Objective::Child will,grasp an object with one hand
then trans'fer. the object to the other
hand, within 20. seconds of the 2nd object
.beingeoffered, for, 80% of the trials on
2 out of 3 consecutive:days.
Materials:*4 Hansow,, DS
No.7
p.124
HELPNo.4.38(3)
HELPNo.4.38(3)p,116
k
a) RightHand to Left Handb) Left"Hand to Right Hand
Rattles in the shape of barbells, a clutch
or grasp ball, spoons, etc. .Try many different
objects to see which dbjects work best viih
your baby.
1. Let the child grasp tbe object with one .
hand then offer second object to the
same hand.
2. Encourage child to transfer the object .
to the other h#nd in order to obtain
2nd object, byksaying, "Put thein .the other hand" and/or "Get fh-E---
'(child's name)."
3. Help her/him transfer the first object,
if necessary4 then encourage her/him to
grasp the second object. 1.
If a child transfers the object to other
hand, praise her/him and mark (+). Show
her/him hovOeplay appropriately with the
2 objects e.g., banging them together,
shaking, etc.
5. If child does not transfer the object to
the other hand, mark (-). Then show
her/him.how to do it. Praise even
thaugh you assisted her/him.
6. When child gets 80% of the trials correct
on 2 out of 3 consecutive days, go on to
next step. 0
Hint: For the 2nd object, use one of child's
favorite toys (a toy you know that s/he
will definitely want).
0;3
S.
Steps:
V.
21
Use the following prompt, if neceJsary:..
a) maximum prompt (i.e., assist childwith a full-hand prompt through most
of the action),
b) moderate prompt (i.e., assist child at
Wrist, through part of the action). ,*
c) minimum prompt (i.e., assist child atelbow, through initial part of the
action).
d) no prot-,-
.
4.400"!
Criterion: / Child will grasp an.object with onehand then transfer the object to theother.hafid, within!hLseconds of the 2ndobject being offered, for 80% of the trails
on 2 out of 3 consecutlye days.
a) Right hand to Left hand
b) Left hand to Right hand
3.>
Suggestions:
HENo.A.
p.1164-5)
A
Hanson, DSp.124 A
No.7
.22
't
1. Let the Child hold a long-handled toyhorizontally with 2'hands. Bring the
toy to a vertical position until thechild releases the toy with one hand andmaintains grasp of the toy with the other
hand.
2. Let the child grasp ad object with one hand,then help her/trim tranaer the same objectto the other hand, if necessary.
3. Make a:small ball of masking tape and letthe child grasp the ball. Encdurage her/him
to pull the iape ball oft with.the otHer
hand.
4. Place a picture sticker on the palm of the.child's hand and encourage Her/him topull it off with the other hand.
5. Play games bringing your child's handstogether.
, 6. GWe child objects that are too big toYhold in one hind and must be held in bothso child becomes accustomed to holding
objects with both hands at midline.
1 0;i
PIPE. itilsra.( PgAct-i 4 6eAsP)
15. Uses Neat Pincer Grasp
HELPNo.4.52p. 118
Objective:.
Materials:.
HELPNo. 4;52
Procedure: p. 118
a.
.47
The thild grasps.a.titly object
t4 sila of.aprecise thumb and index finger
opposition,
Child will independently pick up onetiny object using a pincer grasp within,.
20 seconds of object presentation,for
80% of the trials on 2 out of 3 consecutive
rs).
Use a raisin, dry cereal, other bits of .
food, a tiny bell, a pellet, a button, or
narrowed pegs. 'Be sure the child does not
put unsafe objects in her/his mouth.
1: Place a tiny object on the table or
any surface for the child to grasp
one at a time.
2. Use tiny objects which do no easily
roll away when the child tries to
grasp them,
3. Encourage child to pick up the object,
by saying, "Pick up the , (child's
name)" or "Get the TrEhild's
nameW .
4. pr child picks up the object using a
pincer grasp within the appropriate
time, praise, and mark (+). After"-
child picks up object, show her/him
the appropriate thihg to do with the
object, if necessary.
5. If child does not pick up the object
appropriately, within the appropriate
time, mark (-). 'Show her/him how to
do it, by giving the amount of
assistance needed by the child.
A
4
Hahson, OSp. 124No. 5.3
_tf
If necessary guide your child throughthe activity for a few times'until thechild is able to do this indgpendently.You aould begin the guiding or promptingby'plating.yovr hand entirely over.your.chileg hand and assisting the child inpicking up the object. Over time you
could gradually remove thg prompt.oramount of guidance untilwou merely'touch the child's arm or hand.
Praise child even if you assisted her/him.....,through the motibn. Show her/him what to 4
do with the object when s/he has it in
'hand.
6. Practice this task as often is possible
during.the day.
If child gets 80%4of the trials correcton 2 out of 3 consecutive days, go onto the next step.
fr
10/
Steps,:
Criteriod:
49
4,
1. Child will pick up 1 tiny object using .
a pincer'grasp
a) 60 seconds -
b) 45 secondsc) 30 secondsd) 20 seconds,
of object presentation.
go.
'1'4
For each of the abpye steps, u4e the
following prompts, ifjlecessary:.
a) ma)dmum prompt (i.e., assist.child with a
.full-hand,prompt tnrough most of the actiion)
b) moderate prompt (i.e.; assist child at
wrist, through part of the action) .
--
c) mimimum prompt (i.e. assisrchild at elboWl
through' initial-part of the actipn)
d) no prompt
[*precaution: .a) Be sure child does not9
. .put unsafe objeFts in mouth.
b) An adult should be presentwhen working on this activity.]
Child will independently pick up 1 tiny object
using a pincer grasp within 20 seconds of
object presentation for 84 pf the trials on
2.out of 3 consecutive days. 0
lOô
\'1-4
Suggestions:
Hanson, DS
. p. 121
No. 7.3,4
HELPNo. 4.52(3-6)p. 118 .
50
1. Present objects on a-somewhat roughsurface at first to make picking themlip easier, then switch to a smooth surface.
2. Objects with strings and knobs alsowork well for this activity, such as*
pull toy,.balloon on string, yarn,
knobs on blocks,,etc.
3. Place a tiny object in a cup or eggcarton .cup to encourage the child*tograsp the object with her4his thumb
and index finger. .
4. Place a short, colorful piece of string
on the carpet, on the table, or even 'old
the child, where s/he,can easily see and
reach for'it by graspin With her/his
tbumb and index finger.
5.'Provide bits of food at snack time to
encourage finger feeding as well as
neat pincer grasp.
6. For the older delayed child:
1) Let her/him make a collage usingvarious items, such as shells,sticks, macaroni, beads,'twigs,.
4 leaves, string.-
2) Let the child pinch and pull playdough with her/hiS thumb and index'
fingertips.
3) Ltt the child pinch clothes pins.Let her/him remcve the pins placedon the rim pf a can. Let her/him
drop them into_the can, Then lether/him pinch and place the pinson the rim of the can her/himself.
Tactfully provide assistance, if
necessary.
kIP M oro (2-
19. Places Circle, Square, Triangle Shapes into Form Board
Objective:
Materials:
,Procedure:
53
When presented with a form board with atircular .hole, a square hole, and atriangula.r hOle,.child will andependentlyPlace the 3 shapes (circle, square, triangle) .
into the appropriate holes, within oneminute of presentation of the shapes, for
..80% of the trials, on 2 out cf 3 cpnsecutive
days,
Shapes; shapebox; shape puzzle; form board.
1. Place child in a comfortable.position,. with arms and hands free to manipulate
shapebox/puz71.e. .
2, Place shapebox so that it is easy forchiid-to manipulate e,g, loW enough.so .
that child can see holeS in which toput shapes in.
3. Present shapes in front of child. Give
cue, "Put the in, (name) ".
4. 1f child places the correct shipe inthe appropriate hole independentlywithin the designated time limit, ,
mark (+), and praise child. .
5. If child does not place the correctshape in the appropriate hole inde-pendently, within the designated timelimit, mark (-). Show child how to
complete the task. Remember to praise
child even if you helped her/him.
6, When doing this task, other activitiesto help child learn:
i) Describe theoshapes to the child.
ii) Label the shape e.g. "circle".iii) Allow child to feel and play with
the different shapes.iv) Presentthe shapebox t different ,
angles so that the child is focusingon the shape of the hole and not the
position of the hole.
t..
IMPORTANT: Do these activities afteror before child is asked todo objective.This makes it less confusingfor child.
7. When child gets 80% of the trials correct,on 2 out of 3 consecutive days, go on to
the next step.
ho1.
Steps:
i
1
1
54
e 6
,.
A. 1. When presented with only the circular hole,
child will place the circle shape into the
appropriate hole, within:.
a) 1 minute, b) 45 seconds.
c) 30 seconds
of presentation of shape,
2. When'presented with only the square hole,
dhild will place the square shape intothe approprtate hole, with*
.
a) - 1 minuteb) 45 secondsc)' 30 seconds
of presentation of shapes,
3. When Presented with a circular hole and a
square hole, child will place the circle
and square shape into the appropriate
holes,..within:
a) 2 minutesb) 1 minute
of presentation of shapes.
.4. (Then presented with only the triangular
hole, child will place the triangular shape
into the appropriate hole, withinL,'
a) 1 minuteb) 45 secondsc) 30 seconds
of presentation of shapes.
%
5. When presented with a circular hole, a square
hole, and a triangular hole,'child will
independently place the 3 Shapes'into theapprqpriate holes, within:
a) 5 minutesbA 3 minutesc) 1 minute
B. For each Of above steps, 'use the fallowing
prompts, if necessary:.
a) maximum prompt (i.e..assist child with afull.lhand prompt thrOugh most of task);.
b) moderate promptAi.e. assist child at wrist
through part of task)k..c) minimum prompt (i,e. agsist child at elbow
through initial part of the taskl
d) None. '
e .
:.
..
o
4
:
,
,
Criterion:
i,
1.
,t
4,
,
,
55
Whenyresenied with a form board with acircular,hole, a .square hole, and a
triangular hole,rchild will independently
place the 3 shapes (circle, square;triangle), into the appropriate holes,within oneminute of presentation ofthe shape, for 80% of the trials, on2 out of 3 consecutWe days,
,
.112
-
,
Form'Board Suggestions
A. Round Shape:
4
HELP
No.1.7.1(1-6)"
p.25 -
56
I, Let the child place small uice cans in
matching holes cut in a milk carton.
2. Let the child place pegs in a pegboard.
3, Teach the child tophelp you put round lids
on containers Sbch as thermos bottles; dusting
powder containers. (S/he cannot twist them
yet,)
4. Make round indentations in the sand or.dirt
while at the beach or at home and let the
child place rocks of the same size and shape
.into these indentations. Other materials
which can be used for thfs gaMe are bottecovers, poker chips, and circles made from
foam, wood, plastic or sponge,
5. Formboards - General Suggestions::.,
a) Start with one circle piece and one hole
in the formboard.
b) Start with deep holes cut into the form-
board and with pieces which fit in
completely. Let the child see thedifference in putting it completely in,
having it on the board or having it
partially in.
CI Start with a piece with a large knobbed
handle. Handles can be made by gluing
on small; empty spools of thread, large
beads, wooden knobs, etc. Later, use,
smaller handles made with small pieces
of wood, plastic, slionge, large screws
or nails.to replace the larger handles.
d) Let the child feel the round puzzle
piece and the inside edges of the form-
board.where the round piece fits. You
may want to line parts of thepuzzle-with textures to aid the child.
e) Give the.child time to learn by trial
and error before you begin to direct
.some of her/his efforts.
f) Ask the child to put the circle back.in
the board after s/he has removed it..
Point to the hole if.the child 4oes not
respond or appear.to understand. . Lf more t
help is needed, show the child how to put
the round pieCe into the hole and describe
to the child what you are *doing. Encourage
the 'child ta repeat your action.
lij
'
.0
HELPNo.1.71(1,6)p.25
B. Square Shape: .
HELPNo1.86(2-4)p.29
57
g) If the cbild cannot get into the hole
and:appears to be tiring or becoming
frustrated, help her/him. Place yot
hand near the bole. The child can .
use your hdr(d as a backstop and you
can help.slide the piece in the hold.
h) Help the-child by guiding the piece in
the hole by holding the piece with the
child, The child neeenot let go of the
piece as lgng as s/he can consistently
put it in the hole,
6. Use a board or make one with one large and
one small circle. Let the child try to
put the pieces in correctly, Should the
child plAce the small one in the large hole,
do not say "No, that's the wrong hole" or
"Nd7Fut it here." Let the.child make her/
hiS own corrections. If s/he does not
correct herself/Omself, point.out the error
in a friendly, helpful way, ,Encourage her/him
to try again.
Make spare holet in the sand at the beach
ustng square boXes, iiieces of wood, bTocks.
Let the child put the square object into
the matching hole.
2. Use a formboard with circles and squares.
3.. Suggestions4for making formboards out of
scrap materials.
a) U-s-e heavy cardboard to make a formboard.
Cut out squares with a razor knife. Glue
the squares together to make the puzzle .
piece. Glue the rest of the cardboard
together to make the puzzle board. The
thickness of the puzzle piece may be
greater than the pulJe board.
b) Use heavy cirdboard for the Tormboard,but
a different material-fór.the:thaped pieces.Inverted_plastic ice cream cups and spray
can covers can be used for.cirPles.- Half
pint milk cartons or wood'or plastic toy
blocks make good squares,
c) Use styrofoam and sponge. Packing styro-
foam and sponge are easily cut for,
appropriate shapes.
d) Use an osld telephone directory for the
formboard. The depth of the hoTes can
be quick19 changed by flipping.theyages,*
11 4'
a.
58
C. Triangle Shape:
r---1, Refer to Suggestion A (Places 'round
piece tih formboard), Be sure to
point out the triangle's angles and
points.
2. dut triangles out of wood, foam,sponge, plastic or find triangular
boxes and containers. Take them to
HELP the beach and make triangular holes in
No1.114(1-3,5) the sand. Let the child put the
p. 37 triangular objects into the matching
holes.
3. Use a formboard with a combination oftrianglet, circles and/or squares.
4, Use a fonmboard with three triangles
of different.sizes. Let the child :
remove the triangles;from the formbaard. Arrange the triangles so thecorrect triangle is next to the hole
in which it belongs. Place the triangles
at random after.the child can successfullymatch them to the correct hole,.
9
a
115
Pgz- itexze .
3. Matches Objects to Pictures
Objective:
1,
Materials:
Procedure:
r.
When presented with a choice of:
a) 3 different objects (1 target object,
2 distractor objects), child willcorrectly point to or touch the object'
that'matches theetarget picture, within
20 seconds arthe'verbal 'cue, "Find tile
onelthat's the same,". for 80% of the
trials, on 2 out of 3 consecutive days.
b. 3 pictures of diffei'ent objects (1 target
. picture, 2.distractor pictures), childwill.correctly Oint to or touch the
. picture that matches the targerobject,within Nkseconds cif the verbal cue, "Find
the one that's the same," for 80Z'of
the trials, on 2 out of 3 consecutive days.,
Target and disti-actor objects and pictures.
(Use simple, familiar objects, objects that
the dhild uses in daily livihg.)
0 I. Present an array of objects/Octures of
objects consisting of the target object/
picture and the required number of distractors.
(in the caseof Step Al, there will be no
distractor objects/pictures.). Present the
objects/pictures in different positions on
each trial.
2. Encouratie child to watch you setting up
.the array, without reaching for the objects.
Use cue, "Put your hands down."
3. Hold target object/picture in haneor place
it in front of array. Encourage child to
attend to target object/picture. YoUmay
label.the object/picture for the child.
Then ask child to "Find the one that's Oe
same." (Emphasize "same".)
4. If child reaches for or points to correct
match, within 20 seconds, mark (A-) and
praise child. Tell child "good, you found
the one that's-the same." May label the
target object again. 'SW./ child how the
object and its corresponding picture is the
same.
5. If child does not.reach for or point to
correct match, within 20 seconds, prompt
child givino only as much assistance as is
needed.
dfe
S.
, Mark (-) if you had to prOmpt child morethan the objectiVe states.,
6. Praise child even if you had to prompt her/him
to respond corredtly. tell child, "Good, you
fotznd the one that's the same."4 May label
the target object again. Show child how the°
object and .its correspondifig picture is the
same.
7. After child completes match, may work onother goals/directions that the child is
learning e.g., "Give me", "Put in." .
4
Steps:
Criterion:
9 ":
A. 1. .When presenteb with a choice of 1 object/
picture (a target object/pictures no dis-,
.'tractor aject/picture), child will tor-rectly,point.to or touch the respectiveobject or 'picture that matches the target'picture/object within 20 seconds of theverbal cue, "Find the one that's the.ame."
2. When'presénted with a chbice of 2 objects/pictures' of 2 different objects (1 target
object/pTcture, and 1 distractor object/picture), child will correctly point to
or touch the raspective object or picture
that matches the taraet picture/objett,within 20 setonds of the verbal cue, "Find
the one that's the same."
3." Wh.en presented with a choice'gf 3 objectsi/ ,
pictures of 3 different objects (1 target
object/picture and 2'distractor,ob1ects/pictures), child will correctly point to
or touch the respective object or. picture
that matches the target picturt/obieKt,within 20 seconds of the verbal cue, "Find
.the one that's the same."
-
4. For each
,
of the above steps, use the following
prompts, if.necessary.
0 maximum prompt 'i.e., point to thecorrect object/picture and bring the
child's hand to withln 3 inches of the
correct object/picture.
ii). moderate prompt i.e., holding down
distractor picture/object and.pointingto the correct match.
iii) minimum prompt i.e., pointing to the
correct match.
iv) no prompt
When presented with a choice of:
a) 3 diffarent objects (1 target object,
2 distractor objects), child will cor-rectly point to or touch the object that
matches the target picture, kithin 20,sec-
ends of the verbal cue, "Find the one that's
the same," for 80% of the trials, on 2 out
of 3 consecutive days.'
A
4
,
a
.%
r
b) 3 pictures of different objects ( 1 targetpicture, 2 distractor pictures), the4ildwill correctly point tO or touch the pictdre
', that matches the target Object, within 20.seconds.of verbal cue', "Find the one that'sthe same," for 80% of the trials on 2 out
'of 3 consecutive days.
..
3
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.Syaaestions:
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No. '1.107p. 35
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11
I. 'Start with photographs of the objects.If they are pot available find pictureswhich closely,resemble the objects. . 0
2. Show tile child a'familiar object. Name it
tor if the child can verbalize, let her name
it. Show the child a picture of the same .
_object. Name it or have the child name it.Show the child both the object and thepicture 'and compare them, Talk about their,
p sameness, point out the' obvious similarities.
3. Show the child a familiar object. Then
show him two pictures (one of the object,
the other of a very dissimiilar object).
Ask her to point out the picture whichmatches the object. .
4. Show the child a familiar picture of
a familiar object. Then show him two objects
(one identical to the pict)ee, the other,
very dissimilar). .Ask him to give you the .
object which matches the picture.
5. .Show the child a picture of .a familiarobject in the house or classroom. Have
the.child find the actual object in thehouse or classroom. -Be sure it is near
the child and within his reach.
a.;
..
0:
- pRe AGAbElt4 IC.
. 2. .Discriminates Ojects. .
Objective:
._
Material:
-.Procedure:
-.
r
51
t;
When presented with a choice of 3 objects
(a target object and2 distractor objects),
child will correetly point to or toucb the
target object within 20 seconds .of the verbal
cue, "Find the ," for 80% of the trials
on 2 out of 3 cOn-iiE&ive days, for a total
of 10 objects. .
.Target objects, distractor objects.
Use: a) objects that are familiar to the
child.b) objects that are functional for
the child-i.e. objects that the'
child uses in her/his daily activities.
1. Present an array of objects consigtinq of the,
target object and the required number of ..,
distractor objects. (In the case.of Step
Al, there will be no distractor objects.)
Present the objects in different positions
on each trial.
.2. Encourage child tO watch you setting up the
array, without reaching for the objects.
Useftue, "Put your hands down."
3. When array is set up, askIchild "Find the
." (Emphasize label of target
object.) Other cues: "Show me ."
..
4. If child reaches for or Points to corre,ct
object within 20 seconds, mark (+) and'
praise child. Tell child "Good, you found
the " or repeat the label of thetarg-E-53ect, e.g. "Ball." Give child
an opportunity to play with the object for
a short while before proceeding to next
trial.
5., If child does not reach for or point to
correct object independently withAn 20
seconds, prompt child using only as much
prompting as is needed (See.Step 8). Mark
(-) if you had to prompt child more than
the objective staths.
6. Praise child even if you had to prompt
her/him to respond correctly. Tell child,
"Good, you found the __" or repeat the
label of the target oF.f&t. Give child an
opportunity to play with the object for a
short while before proceeding to next trial:
-
.
52
7. After child identffies coreect object,child may work on other goals e.g. followingdirections, prepositions, functional object
use. 4
S. Suggested Objects: .
is....
cup ball brush (other toys)
spoon gbok comb
plate doll cookiebox crayon chair
I.
4
CS
N.
Criterion:
53
4.
A. 1. When presented with a choice of 1
object (a terget object, no distractor
objects), child will correctly pointtoor tolich the taraet object within 20 seconds
of the verbal cue, "Find the (taraet object).;
2. When presented with a choice of 2 objects
(a target object, and 1 distractor object), ,
child will correctly point to or touch the
target object within 20 seconds of the
verbal cue, "Find the (target object).
3. When,presented with a choice of 3 objects
(a target object, and 2 distractor objects),
child will correctly point to or touch the
target object within 20 seconds of the
verbal cue, "Find the (target-object)'.
B. For each of the above steps, use the following
prompts, if necessary.
i) maximum prompt (i.e. point to thecorrect object and brim] child's hand
to within 3 inches of correct object.),/
ii) moderate prompt (i.e. holding downdistractor object and pointing to the
,target object)
iii) minimum prompt (i.e. pointingto target
object)
iv) no prompt
When presented with a choice of 3 objects
(a target object and 3 distrector objects),
child will correctly point to or touch the
target object within 20 seconds of the vesrbal
cue, "Find the ", for 80% of the trials,
on 2 out of 3 consecutive days; for a total of
10 objects.
123
. Suggestions: 1.
pHELPNo. 1.93 (1-5)
2.
3.
p. 31
4.
5.
1
54
,
Label objects for the child. Discuss
things around her/him.
Discuss body parts and clothing when you .
bathe and dress the child.
Discuss the food, the utensils, the kitchenfurniture and things when you feed the child.
Give the child simple directions to seeif s/he knows the names of things.
Discuss what you routinely see when youride the car, such as traffic lights, stopsigns, trucks, buses, fire stations.
*
1,
I
4.
..
,
e
(Social)6. Responds To Own Name
Objective:
Materials:
Procedure:
Hanson, DSP. 172
CarolinaP. 217, 21915c, 15e
12
The child will turn toward a person calling his/her name
from a distance of 5 feet within 10 'seconds of verbal cue,
for 80%,of the trials tn 2 put of 3 consecutive days.
None
1. Child should be occupied-in with an activity - not
attending to person calling his/her name:-
2. Always use the saMe name for.your child. If the child's
name is Jim, call him JiM and not Jimmy or Jack. It
N,makes it easier for baby to learn his correct name. .
.,.
[3. Standing'several feet-away from the child, call his/her
.
name.softly and olcserveJlis/her reaction.
4. If he/she does not respond, prompt by:
a. Calling his/her name a little -louder, or )
b. Pair calling his/her name with a gentle touch which
guides him/her to turn his face toward the source of
sound. '.
c. If necessary attract the child's attention by physi-
cally turning the child toward you when you call her/
his name or bx..using another attention-getter such as
a toy. GradudIly remove it until you need only say
the child's name to get her/his attention._
d. Gradually reduce the prompt so that he/she learns to
respondito the sound of his/her name being called.
Also allow increasing time (1 second, then 2 and 3
seconds) efter calling his/her name before providing
hfm with assistance in turning his/her head toward you.
12D
4
Steps:
13
4.
The child will turn toward a persOn calling his/her name from
a distance of:
1) 1 foot, within 10 seconds of verbal .cue.
2) 3 feet, within 10 seconds of verbal cue.
3) 5 feet, within 10 seconds of verbal cue.
From the above steps, use the following prompts if necessary:
a) turn child's head to face parent0 turn child's head part wayc) tap child's cheek in direction of parent
d) no prompt (independently)
Criterion: The child will turn toward a person callino his/her namewithin 10 seconds of verbal cue, for 80% of the trials on2 out of 3 consecutive days.
14
Suggestion:1. Call the child by name often. For example: d6ring-
feeding or dress-ing, "Jim, r'aise your hands."
2.. Vary yoOr pos,ition and place in the room as well as the 4
pitch and intensity of your voice as you call to him/her.
J.
..
t
a
I
li
0
Appendi x BA
Curri cul ar Objecti ves,
/
-
4
t
,
I
tr
I,
,
I
. GROSS MOTOR: Tummy (Prone)
Objecti yes :
1-. Lifts Head to Clear Nose
" Child Will lift head high enough to clear liose from floor, maintain this
position,for5 to 8 seconds, before turning head to one side, while lying.
on tummy, for 80% of the trials on 2,out of 3 consecutive days..,
2. Forearm Support Lifts Head td.450 in Midline
Child will lift head at 450 angle to the floor for a duratiop of one
minr4e keeping head in midline while lying on tummy with forearm sopport,
for 80% of the trials on 2 out of 3 consecutive days.
3. Rolling Tummy to BackChild will roll from Stomach to back without assistance'within one minute
when placed on the floor with favorite object out of reach, for 80% of
the trials on 2 out of 3 ,consecutive days.,
4. Supportir4 Weight on extended arms, head 900, Chest Off Floor
Child will lift head at 900 angle to the floor while supporting weight on
open hands-, straight arms- and chest off floor or a.minimum of 1 minute when
'lying on tummy for 80% of trials on 2 oUt of 3 consecutive days. c%
5. Supporting Weight on Forearms and Reaching Out with One Arm
Child placed on tummy will reach out.to swipe or.touch an object, within
20 seconds of object presentation'while supporting self on opposite -fore-
arm,,for 80% of the trials on 2 out of 3 consecutive days. .
6. Child Alternates Between FOl-earm Sup ort and "Arms Back" Activit )
When lying on his .stomach, the child spontaneously alternates between
arching his back with his elbows bent and off the supporting surface--
hands near ears, and steady support on elbows with head at 900 angle ,for
80% of the trials_on 2 out of 3 consecutive days.
7. Locomotion Forward on Tumm Usin Arms Crawlin , then Arms and Le s
Child will independently move forward, stomach on floor moving one leg
at .a time in an alternating pattern) .a distance of 24 inches (2 feet;
61.0 cm) within one minute after a cue is given for 80% of the trials
. on 2 out of 3 consecutive days'.
8. Assumes Independently a Hands and Knees Position With the'Tummy Off the
Floor ,
Child will ass,ume a hands and knees position with tummy off the floor inde-
pendently within 20 seconds of verl?al cue and maintain this posttion for 30
seconds for 80% of the trials on 2 ou of 3 consecutive days.,
,
i9. Rocking Forward and Backwards in a Hands and Knees Position
Child will independently assume a hands, and knees position and shift weight
forwards and backwards 4-5 times for 80% of the trials on 2 out of 3 con-,
secutive days.
I .
1 2 ,)
.3
;
.0
4 GROSS MOTOR: Tummy (cont'd)
10. . Pla s with To s in an Asymmetrical Sitting, Sidelying Position (Activity).
Chi17( wil manipu ate o jects'p aces to t e si e in an asymetrica a
f sitting, half sidelying position when presented with toys, for 80% of the, trials on 2 out of 3 consecutive days. .
11. Moves Forliard on Hands and Knees (Creeping)Child will independently move forward 2feet in_an alternating pattern onhands and knees (one !land and.opposite knee forwards then other hand and'opposite knee forward, and so on) with stomach off rloor within one minuteafter cue is given for 80% of the&trials on 2 out of 3 consecutive days.
12. Reaching, with One. Arm on Hands and Knees
Child.will reach and touch an.object at an arm's length while supportingweight on one hand and knees within 20 seconds of toy presentation for80% of the trials on 2:out of 3 consecutive days.
0
13. Child Will Move Forward on Hands and Feet; "Bear Walking" (Activity)Chilcinl move forward on haTai--aTa feet two feet wiTEin 20 seconds ofcue for 80% of the trials on 2 out of 3 consecutive days. This is alsoknown as "plantigrade creeping" or "bear vilking"..
14. Child Will Creep Independently Up and Down 2-3 StairsChild will creep independently up and down 2-3 stair steps (about 7 inchhigh stair step)* for 80% of the trials on 2 out of 3 consecutive days.*or hitches down on bottom. Hitching is scooting on bottom while sitting.
<I
GROSS MOTOR: Back (Supine)
Objectives:
1. Turns head side to side in res ohSe to visual'or auditor stimUli'While
on'back. j
Child will turn "head freely side to Side in response to visual Of- auditory sttmuli
, while on his back wittiiii" 20 seconds of cue ibr 8 Of'tke trialt 2-61i1 of 3.
'consecutive days:
;,c- Child bends and.strai htens arms and legs in a "kicking" m4ion, kicking legt"
a ternate y. ActivityChild will bend and straighten arms and legs in a "kicking" motion, kfcks (Tegs
alternating) within 15 seconds of presentation of toy or an adult or spontariegusly
for 80% of the trials on'2 out of 3 consecutive days.
3. Child will bring her/his hand(s) to her/his mouth.
A. Child will bring right and/or left hand to mouth spontaneougly for 80% ofthe
trials, on.2 out of 3 consecutive days.. .
B. Child will bring both hands to mouth and/or midline spontaneously or wittiin:.
20 seconds of presentation of toy for 80% of the trials on 2 out of 3 consk-futiv
days.
4. Child maintains head in midline position, while on back.
Child maintains head in midline for 60 seconds while on back for 80% of the 'trials
on 2 out of 3 consecutive days. .:
5. Child williplay with knees, feet in the air, while on its back.
Child will reach and touch knees and feet in the air, while lying on his/her
back within 20 seconds of physical prompt or spontaneously for 80% of the triaTs
on 2 out of 3 consecutive days.
6. S etrical rolling side tO side.Child will roll symmetrically side to side when placed in supine and recover t-D a
midline position within 20 seconds of physical prompt or spontaneously for 80% of t
trials on 2 out of 3 consecutive days.
7. Rolling back to tummy.Child will roll continuously from back to stomach without assistance within 30 sec
onds when Oriced on the floor surrounded by several favorite objects out 'of t'each
for 80% of the trials on 2 out of 3 consecutive days.
8. Child will lift bottom off the floor, pushing with feet flat, while on its back. .
170711137).Child will lift hips (bottom) off the floor maintain for 20 seconds,.wile
lying on her back and pushing with feet flat on the -floor for 80% Of the trials..
for 2 out of 3 consecutive days.
9. Child lifts head while on its back.
Child will lift head one inch whilelying on her back, within 20 seconds of I
presentation of an object or spontaneously for 80% of t ials on 2 out of
3 consecutive days.
13i
GROSS MOTOR: Upright
Objectives:
1. Hold Head Steady - Held at Shoulder
Child will hold head steady in an upright position for 20 seconds while
held supported at the shoulder.for 80% of the trials bn 2 out of 3 consecutive
days.
2. Hold Trunk Steady - Held at Hips
Child will hold body (trunk) and head upright and s'teady for one minUte when
held at hips against adult body for 80% of the trials on 2 out of 3 consecutive'
days.
3. Sits Supported - Head Steady
'Child will hold head in an upright position to the body when placed in a
sittingposition. Child will maintain this upright position for one minute
for.80% of the'trials on 2 out of 3 consecutive days.
4. Sits with Minimum Supports'
Child will sit for one minute.with body in upright positfon (upper body
straight, lower back rounded) when held at the hips for 80% of the trials
on 2 out of 3 consecutive days.
5. Sits Self-Supported by Arms and Hands
Child will sit independently self-supported by ars and hands for one minute
when placed on firm surface, for 80% of the trials on 2 out of 3 consecutive
days.
6. Sits, No Support.Child will sit independently with no support, head and back straight, for
oneminute when placed in a sitting position on a firm Surface, for 80%
of the trials on 2 out of 3 consecutive days.
7. Raises Self to Sitting from Back
Child will move from lying on back or stomach to sitting by rotating
toward the side, pushing up on straight arms, rotating the hips and,upper
legs, and straighteningto sitting position within 20 seconds of verbal
cue for 80% of the trials on 2 out of 3 cont.icutive days.
8. Bears Own Weight.Child will support body weight for one minute when held at chest, feet flat
on theefloor for 80% of tfIWNtrials on 2 out of 3 consecutive days.
9. Stands with Minimum Support.
Child will support own body for one minute when placed in standing position,
feet flat on the floor when held at the hands by parent for 80% of the
trials on 24out of 3 consecutive days.
4
132
#,
a
GROSS MOTOR: Upright (cont'd)
10. Stands at Furniture -
Child will Stand in an erect positionOtt; feet'flat on tbe floor and hands
on top of-furniture when placed facing furniture for at least one minute
for 80% of the trIals on 2 out of 3 consecutive days.
11. Pulls to Stand
Child will pull self to standing by coming to kneeling, p ling to half
kneeling, then to a straight standing position facing a fu niture support
within 20 seconds of verbal cue and maintains this position for 30 seconds
for BO% of the trials on.2 out af 3 consecutive days.
12. Lowers Self from Standing to Sit
Aen standing by furniture for support, the child will lower self from
.
standing to sittina position within 20 seconds of verbal cue tor 80% of
the trials on 2 out of 3 consecutive days.
13. Cruises'(Walks Holding Onto FurnitUre)
Child will walk sideways 10 steps, while supporting her/Himself at furniture,
within one minute of verbal cue for 80% of the,trials on 2 out of 3 consecutive
days.
14. Walks.with Support ,
Child will take 5 steps forward when supported at the hands, the shoulders;
or at hips, within one minute of physical cue (holding child's hands) for
'80% of the trials on 2 out of 3 consecutive days.
15. Stands, No SupportChild will stand alone without support for one-minute within 20 seconds of
verbal cue for 80% of the trials on 2 out of 3 consecutive days.
16. Walks When Led by One Hand
Child will walk 5 steps forward when led by one hand within one minute of
physical cue, for 80% of the trials on 2 out of 3 consecutive days.
17. Stoops and RecoversChild will stoop to floor from standing and then raise self to standing
position again within 20 seconds of verbal cue for 80% of the trials on
2 out of 3 consecutive days.
18. Walks Alone, No Support
Child will take 10 consecutive flatfooted steps forward within one minute
of verbal cue for 80%of the trials on 2 out of 3 consecutive days.
Additional Activities
A. Upright (Kneeling)
B. Upright (Standing)
GROSS MOTOR - ADVANCECOACTIVITIES
I. Advanced Walking Skills
1. Walks'Sideways tActivity)..Child wiTT move sideways without support '1 to steps in either direction;
(feet are not expected to cross over),within 0 seconds of verbal cue for.
4- 80% of the trials.on 2 out of 3 consecutive days.
2-4 Walks Backwards (Activity)-Child will independently walk in a backward direction for 6 feet within
30 seconds of Verbal cue for 80% ofthe%trials on 2 out of 3 consecutive
days.
3; Pulls Toy Behind While Walking (Activity)
The child will pull a toy' behind him while walking independently for a
distance of 6 feet within 30 seconds of verbal cue for 80% of the trials
on,2 out of 3 consecutive days.
4. Carries Lar e To While Walking (Activit )
Teci carries a arge o ject with one or both hands without assistance
for a distance of 6 feet within 30 seconds of verbal cue for 80% of the
trials on 2 out of 3 consecutive days.
5. Pushes and Pulls Large Toys or Boxes Around the Floor (Activity)
The child will push (pull) large toys or boxes around tli-J71-156F independently
for a distance of 3 feet within 30 Secorids of verbal cue for 80% of the
trials on 2 out of 3 consecutive days.
6. Stands on Tiptoes (Activity)The child comes up on her/his toes for 10 seconds within 10 setonds of
verbal cue'for 80% of the trials on 2 out of 3 consecutive days. .
7. Walks on Tip-Toes a Few Steps (Adtivity).
The child stands on tip-toes with hips and knees straight and takes 2 out
of 3 steps forward independently within 30 seconds of verbal cue for
80% of the trials on 2 out of 3-consecutive days.
8'. Walks on Tip-Toes Ten Feet (Adtivity)
-The child will independently walk on tip-toes for a distance.of 10 feet
within'30 seconds of verbal cue foi. 80% of the,trials on 2 out of 3
consecutive days.
II. Running.
9. Runs - Hurried Walk Activ
'The child in able to walk idly maintaining one foot on the ground at all
times. (Body is held stiff] upright with eyes fixed on the ground)) for
80% of the trials.on 2 oUt. 3 consecutive days.
0. 'Runs Fairly Well (Activity)
Objective: The child is able to rUn independently (an activity jn which
neither foot is touching the grOund during the same phase of the movement
with the child being balanced, her/his arms and legs alternating smoothly)
for 80% of the trials on 2 out of 3 consecutive days.
GROSS MOTOR - ADVANCED ACTIVITIES - cont'd
11. Runs and'Sto s Inde endentl , Avoidin. Obstacles Attivit
Tecidis ab e.to in epen entyrun and stop an avoid obstacles without
'falling for 80% of the trials on 2 out of 3 con cutive days.
12. Make Sitarp'Turns Around Cornett'When'ROnninq Activityl
The child is able to turn easily when running without losing balance or
falling down for 80% of the trials on 2 out of 3 conseptive days.
III.-Recovery. Activities
13. 5._qui)Child has sufficient balance to play on the floor for 2 minutes in a squatting.
position for 80% of the trials on 2 out of 3 consecutive days.
14. Picks U 'TO From Floor WithOUt.Fallin Activit
C ild will'squat down or bend'over and.pick up-a toy, and maintain
sufficient balance to stand up again within 20 seconds of verbal cue for
.80% of the trials on 2 oUt of 3 consecutive days.
15. Bends OVerand Looks Through Legs (Activity)
The child it 'able to bend over and look through her legs for 3 seconds within
.30.,seconds of verbal cue (knees slightly bent as she loOks backwards between
the legs.) for 80% of the trials on 2 out of 3 consecutive days.
IV; Stair and Climbing Skills
16. Walk§ Upstairs With One Hand Held (Activity)
Child Will walk upstairs while holding the hand of an aduli and placing one
Ibot up ind then moving the other foot up onto the same step within oneminute
rs Holding Rail - Both Feet on Step (Activity)./1)
.of verbal cud for 80% of the trials on 2 out of 3 consecutive days.
17. Child Will Walk Upst
Childwill independently walk up 5 steps holding onto a railing or wall with
one hand, placing both feet on one 'step within 1 minute of verbal cue for
'$0% of the trials on 2 out of 3 consecutive days. (The child'S feet do not
yet altellhate.)
18. Child Will Walk U stairs Alone - Both Feet on Step (ActiVity)
Child will independently walk up 5 steps without the use of railing or
wall placing both feet on one step within 1 minute of vetbal cue for 80%
'of the trials on 2 out of 3 consecutive days.
19. Walks DOwnstairs With Ube Hand Held (Activity)
Child will walk downstairs while holdThrffii-Thand of an idult and placing
one foot down and then moving the other foot onto the same step within one
minute of verbal-cue for 80% of the trials on 2 out of .3 consecdtive days.
20. Child Walks Downstairs HoldirRatl':. Both Feet on Step (Attivity). ,
Child will independently wal 5,steps Kolding.onto a railing or wall
with one hand, placing both -feeton.one step within 1 minutecOf verbal cue
for 80% of the trials on 2.out of 3 consecutive days. (The child's feet
do not yet alternate.) .
"
21. Child Will Walk-Downstairs Alone - Both Feet'on'Ste Activit
1 u wi in epen ent y wa own steps, p acing .oth eet on one step,
within 1 minute of verbal cue for 80% of the trials on 2 out of 3 consecutive
days. (The feet do not yet alternate.)
11
GROSS'MOTOR - ADVANCED ACTIVITIES - cont'd
22. Child Will Walk Upstairs Alternatin4 Feet (Activity).The,child will independently walk up 5.regular size stairs without the
use of,a railing or the assistance of an adult within 1 Minute of verbal
cue for 80% of the trials on 2 out of 3 consecutive'days. (Alternating ,
foot pattern is now used.)
23. WalldDownstairs Alternating'Feet (ACtiVity)The child will independently walk down 5 regular siZe stairs withfutrthe
'
use of a railing or the assistance of an adult within 1 minute of verbal
tue for 80% of the trials on 2 out of-3 consecutive days. (Alternatingfoot pattern is now used.) A
24. Gtoes_qp and Down Slide (Activit.)The child will independently climb a ladder and go down the slide within
minute of verbal cue for 80% of the trials on 2 out of 3 consecutive days.,
:Chair Skills.25. C1iMbt'Int6"AdUlt'Chair (ActiVity)
Child will climb int an adult-sized chair within 1 Minute of verbal cue
for 80% of ne trial on 2 out pf.3 consecutive days.
%)-
26. Climb Forward oiIdilt Chair Turn Around and Sit Activit
Child will climb fomard onto an adult chair, turn around and sit &win,
within 1 minute of verbal cue for 80% of the trials on 2 out of 3 consecutive
days. :
0
27. Seats Self in Small Chair (Activity) .
Child will seat self in a small,chair within 30 seconds of presentation of.
chair for 80% of the trials on 2 out of 3 cOnsecutive days.
Skills - Throwing/Kicking
28. Throws Ball Overhand Landing,Within Three Feet of Target (Activity)
The child, in standing position, throws aJball overhand a distance of 3 feet,
vi.thin2Osecondsofverbalcuefor80%ofthetrialson2outoficorisecutive.days. (The ball should land within 3 feet of the target.)
29. Child Will Catch Large Ball (ActivitA .
The child in standing position will catch a 12" ball when'the ball is throWrr
to him for 80% of the trials on 2 out of 3 tonsecmtive days.
4
30. Child Catches Ei.ht Inch Ball (Activit )
The c 1 in stan.ing position wi catch an 8 inch ball when the ball is ,
thrown to him for 80% of the trials on 2 out of 3 consecutive days.
32. Child Will Kick Ball Forward ActiVit )T e c ild in standing position will independently kick a ball with one foot
within 20 seconds of verbal cue for 80% of the trials on 2 out of 3 consecu-
tive days. . .
33. Throws Ball Underhand in Sitting (Activity)TlieEhicithrow the ball underhand a distance of 3 feet within.20 secondsof verbal cue for 80% of the trials on 2 out of 3 consecutive days.
34. Throws Bali Into A Box (Activity)
The child in standing position will throw a bali.into a box which is 1 foot
away within 20 seconds of verbal cue or 80% of the trials on 2 out of 3,
Ionsecutive days.
3 t3
'GROSS MOTOR - ADVANCED ACTIVITIES - cont'd
31. Walks Into Large Ball While Trying to Kick It (Activity)
. The child, unable as yet to kick a ball, will walk toward the ball and move
it forward 1 foot by bumping-her/his. leg or*body into it when given the
verbal cue "Kick the ball", for 80% of the-trials on 2 out of 3 consecutie
days.
VII. Balance Skills
35. Walks With Assistance On Eight'Inth Board (Activity)
The child will walk at least three feet on ai 8" wide balance board with
someone holding her/his hand.within 30 seconds of verbal cue for 80% of the
trials on 2 out of 3 consecutive days. (The board is raised 1-2" off floor)
36. Walks Independently on Eight Inch Balance Board (Activity)
Child will walk independently 6 feet on an 8 inch balance board within 1
minute of verbal cue for 80% of the trials on 2 out of 3 consecutive days.
(The board is 8 inches wide, 6 feet long and one to two inches off the floor.
The child will walk the entire length without assistance.)
37. Walks Between Parallel Lines Eight Inches Apart (Activity).
Child will walk between parallel lines eight inches apart for a distance of
6 feet-within 30 seconds of verbal cue for 80% of the trials on 2 out of
3 consecutive days.
38. Stands on One Foot With Help (Activity).
The child is able to lift up one foot and balance on the other when 'supported
for 10 seconds for 80% of the trials on 2 out of 3 consecutive days.
39. Child Will Imitate One FOot Standing (Activity).
Child will imitate one foot standing .1-or 1-2 seconds within.30 seconds of
verbal cue for 80% of the trials on 2 out of 3 consecutive days.
40. Tries to Stand On Two Inch Balance Beam (Activity)
Thechild will independently stand on a 2 inch balance beam for 10 seconds
balancing only on 1 foot within 30 seconds for 80% of the trials on 2 out
of 3 consecutive days.
SELF-HELP,
A. Feeding
Objectives:.
1. Takes Food Off SpoonWhen mashed table food on a spoon is placed 1" from thild's mouth, child will
bring head forward and remove food from spoon by closing lips around spoon,
within 20 seconds of presentation of spoon, for 80% of the trials, on 2 out
of 3 consecutive days.
2. Bites Food (Activity) ..
Child will take one bite off a cracker/cookie held by an adult, within 20
,seconds of presentation of cracker/cookie, for 80% of the trials, on 2 out
of 3 consecutive days.
3. Finger-Feeds Self.
Child will pick up a piece of food, place it in his/her mouth, chew and
swallow the food, within l'minute.of presentation of food, for 80% of the
trials, on 2 out of 3 consecutive trials.
4. Chews Food With Munching Patterns (Activity)
Child will make 5 chewing movements jaw moves up and down) within 1 minute
of presentation of food in child's mouth, for 80% of the trials, on 2 out of
3 consecutive days.
5. Scoops food, feeds self with spoon
A. When a spoon with food is placed in child's hand child will bring spoon .
to his/her mouth, take the food off the spoon within 2 minutes of presen-
tation of spoon, for 80% of the trials, on 2 out of 3 consecutqe days.
B. When spoon is placed in tray/bowl, child will pick up spoon, scoop food
from bowl, and feed him/herself 1 spoonful of food within 2 minutes of
presentation of spoon, for 80% of the trials, on 2 out of 3 consecutive
days. J
.
.
6. Uses Fork (Activity)Child will use a fork to,pierce or scoop a piece of food and bring to
his/her mouth within 2 minutes of presentation of food, for 80% of the
trials, on 2 out of 3 consecutive days..
B. Drinking
Obji,ctives:
1. CoordinateS,Sucking,'3wallowing and Breathing (Activitx)
Child will suck and swallow 1 mouthful of milk from a bottle or the breast
within 20 seconds of presentation of bottle or breast, for 80% of the trials,
on 2 out of 3 consecutive days.
2. Holds and Drinks from Own Bottle.
Child will independently hold his/her bottle and drink at least 1 of ligutd
in the bottle without qropping bottle for 80% of the trials, on 2 out of 3
consecutive days.
3. Drinks From Cup Held For Him -aild will take one mouthful of drink from a cup held by an adult, within
20 seconds of cup being brought to child's mouth, for 80% of the trials, on
2 out of 3 consecutive days.
t
$ELF-HELP
Drinking - cont'd
4. Holds and'Drinks From CuE_Child will hold a cup using one hand and take a cupful of drink from the
:cup within 1 minute of presentation of cup, for 80% of the trials, on 2 out
of 3 consecutive days.
5. Holds Cup Handle (Activity)Child will grasp a handle or handles of a cup and maintain his/her grasp for
At least 1 minute within 20 seconds of presentatir of cup, for 80% of the
trials, on 2 out of 3 consecutive days.
6. Pours li uid from small container (Activit 1
Child-will pour i cup of liquid from small container, within 1 minute of
being given the container, for 80% of the trfals on 2 OUt of 3 consecutive days.
!C, Dressing
Objectives:
1. Cooperates with Dreising and UndiTssing
A. Within 1 minute of verbal cue, child will extend:
i) arMs
ii) legsinto sleeves/pant legs, when adult locates hole in sleeves/pant legs for
child, for 80% of the trials, on 2 out of 3 consecutive days.
B. Within 1 minute of verbal cue6 child will pull:
i) armsii) legs
out of sleeves/pant legs, when aduli holds sleeves/pant legs for child,
for 80% of the trials, on 2 out of 3 consecutive days.
2. Removes Sock.Within 5 minutes of verbal cue, child will remOve both,socks independently;
far 80%.of the trials, on 2 out of 3 consecutive days:.
3. Removes Hat;. Places Hat on Head (Activity)
VITTETF 1 minute of verbal cue, child will:
A) remove a hat from his/her head independently,
13)- p1aCe a hat on his/her head independently, ifor 80%;6f the trials, on 2 out of 3 consecutive ddys.
4. Removes Shoes When'Laces Are UndoneWithin 5 minutes of verbal cue, child %till remove both of his/her shoes when
'the laces are undone; for 80% of the trials, on 2 out of 3 consecutive days.
5. Removes A) coat/shirt; B) pullover shirti adult assists with fasteners.
A) Wien given a coat/shirt that is unfastened, child will take it off
independently, within 5 minute% of verbal cue, for 80% of the trials,
on 2 out of 3 consecutive days.
B) When uiven a pullover shirt that is unfastened, child will take it off
independently, within 5 minutes of verbal cue, for 80% of the trials,:
on 2 out of 3 consecutive days.
5ELF-HELP
Dressing - continued
ç.Unzips, zips large zippers (Activity)
Within one minute of verbal cue, child will (a) zip (b) Unzip a large zipper
at least 6 inches independently,"for 80%*of the trials, on 2 out of 3
consecutive-days.
7. Pull ants off; adult assistance with.fasteners
,When child's pants are unfastened, child;will independently take them Off,
within 5 minutes of verbal cue, for 80% of the trials, on 2 out of 3
consecutive days.
8. Puts Shoes and Socks On
A) When given 2 untied shoes and adult assistance in placing shoe on correct
foot, child will put left shoe on left foot and right shoe on right foot
independently, within 5 minutes of verbal Cue, for 80% of the trials, on
2 out of 3 consecutive days.
B) When given a paie off socks, child will put a sock on each foot independently
%within 5 mindtes of4erbal cue; for 80% of the trials, on 2 out of 3,
consecutive days.
9. Pulls Pants Up *When given a pair of pants, child will put them on independently, within 5
minutes of verbal cue, and adult will fasten the pants; for 80% of the trials,
on 2 out of 3 consecutive days.
10. Puts a coat/shirt- b ullover shirt on.
When given a a coat/shirt, b a pullover shirt, child will put on garmet
independently, within 5 minutes of verbal cue, and adult will fasten the
garment; for 80% of the trials on 2 out of 3 consecutive days.
11. Unbuttons; Buttons Large Buttons (Activity)
A) ''!ithin 10 minutes of verbal cue, child will unbutton a shirt/coat that haslarge buttons and take the garmet off independently, for 80% of the trials
on 2 out of 3 consecutive days.
B) Within 10 minutes of verbal cue, child will put a shirt/coat on and button
the large buttons independently, for 80% of the trials on 2 out of-3
consecutive days.
D. (rooming
Objectives:
1. Washes HandsWithin 5 minutes of being asked to wash hands, child will:
a) turn faucet on;b) wet hands;c) soap hands;
d) rub hands together;
e) rinse hands, and0 turn faucet off;for 80% of the trials, on 2 out of 3 consecutive days.
2. Brushes Hair; Combs HairChild will hold brush/comb and make at least 3 brushing/combing actions on hair,
within 5 minutes of verbal cue, for 80% of the trials, on 2 out of 3 consecutive
days.
SELF-HELP
Grooming - cont'd
3. Brushes TeethChild will bring toothbrush to mouth, and make at least 3 brushing motions
on his/her teeth, within'5 minutes Of yerbal cue, for'80% ofthe trials,
on 2' out of 3'consecutive days.
4. Wioes/BlOwi Nose' (ActiyitY)WET-given a facial tissue, Child will wipe/blow his/her qwn nose, within
20 seconds of verbal cue, for 80% of the trials, on 2 out of a'consecutive
days.
5. rie Napkin (ActivitY)hen given a napkini thild will use ii to wipe his/her mouth or hands, with-
in 20 seconds of verbal cue, for 80% of the trials, on 2 out of 3 ,consecutive
days.
6. Dries'HandsWhen given a paper towel/wash cloth, child will dry his/her hands, then
dispose of paper tool independently, Within 5 minutes of verbal cue, for
80% of the trials, on 2 out of'3 consecutive days.
E. Toileting
1. Sits on Potty Chair or on Adaptive Seat on Toilet With Assistance (Ahiv..ity)
Child will remain seated on-a potty chair or on an adaptive seat on toilet
for 3 minutes, when placed on the pOtty by an adult, for 80% of the trials
on 2 out of 3 consecutive days.
2. May be toilet regulated by adult (Activtty)
When placed on the potty at regUiar time intervals, child will eliminate
in the'potty within 5 minutes of being placed on the potty, for 80% of the
trials, on 2 out of 3 consecutive days.
3. Anticipates Need to Eliminate on Time - May Use the Same Word for:Both
'F'unctions.(Activity)Child will indicate his/her need.to eliminate verbally or V gesture, in
time to use the toilet; and when taken to the toilet, will eliminate in
the toilet within 5 minutes of placement on the toilet, for 80% oi the trials,
on 2 out of 3 consecutive days.
4. Takes Responsibility for Toileting Re uires Assistance in Wi in .(Activity).
Child will (a) indicate is/her need to eliminate verbally or by gesture;
(b) go to the bathroom independently; (c) take his/her pants and/or underpants
off; (d) and eliminate in the toilet within 5 minutes of placementon the
toilet, with at least 80% success during the day, on 2 out of 3 consecutive
days.
-
I. AUDITORY RESPONSE.9
Objective:
1. Childtt'behavior.Changes'in reSponSe to soundl(AttiVity).Child will change activity level within 20 seconds of sound presentation,for 80% of the trials, on 2 out of 3 consecutive days.
2. Quiets to familiar voice..(Activity).. Child will decrease activity level within 20 seconds of hearing a familiar
voice, far 80% of the trials, oh 2 out of 3 consecutive days.
Turns head and looks to source of sound.When sound ispresented to side, 900 from midline, within 12" from ear,.child will turn head and look for sound source wifhin 20 seconds of,sound presentation, for 80% of the trials, on 2 out of 3 consecutivedays
II. RECEPTIVE LANGUAGE
Objective:.
1. Responds to own name (Activity).aild will turn toward speaker or change activYty level within 20 secondsof hearing own name c'alled, for 80% of the trials on 2 out of 3 cohsecutive
days
2. Uses gestures to respond to simple requests.Child will respond with correct gesture within 20 seconds of a simplerequest, for 80% of the trials on 2 out of 3 consecutive days, for at
least 5 requests.
3. Stops activity on command "No". (Activity).
Child will stop activity for at least 5 seconds within 10 seconds ofhearing the command "No' , for 80% of the trials on 2 out of 3 consecutive
days. '
4. Follows directions.Ctlild will respond correctly to a one-component direction, within 20seconds of direction being given, for 80% of the trials, on 2 out of3 consecutive days, for at least 5 directions.
III. EXPRESSIVE LANGUAGE.
Objective:
1. Mimi fiew "sounds.(Activit9)571Td5Fill make 1 new sound for 80% of the trials on 2 out of 3consecutive days, forat least 5 new sounds.
2. Laughs. (Activity)Child will chuckle or laugh in response to a pleasurable stimuli,,within 20 seconds of stimuli presentation, for 80% of thetrials on2 out of 3.consecutive days.
142
III. EXPRESSIVE LANGAUGE: Objectives (continued)
3. Responds to sound stimulation or speech by vocaliting (Activity).
Child will_vocaTize within 20 seconds of presentation of sound or
speech, for .90%,of the trials, On 2 out of $ consecutive days.
4. LoOand vOdalizes to his/her*name.(Attivity):
Child will establish eye contact with speaker and vocalize within
30 seconds of hearing his/her name called, for 80% of the trials,
on 2 out of 3 cons&utive days.
5. Makes sounds for,certaih'Oblects.Child will consistently use one sound to identify or'reguest for one
pa cular object or person within 20 seconds of object/person
presentation, for 80% of the trials, on 2 out of 3 consecutive days
for a total of at least 3 objects/persons.
6. Appareqt r6cognition of "own" sounds by vdcaliting similar sounds.
(Uzgiris and Hunt,.1975, cited in,Branston, Eng, Hunt & Vincent, 1978)
tt
Objective:
A. Child imitates activity by'making a sound.
Child will make a similar sound within 20 seconds of hearing adult
imitate a sound he/she (chlid) just made for 80% of the trials, on
2 oUt of 3 consecutive days. -
B. Adult intfiates the activit b'thaking a tbund in child's re ertoire.
Child will make a similar sound within 20 seconds Qf hearing adult
make a sound from child's repertoire, for 80% of the trials,-on
2 out of 3 consecutive days. ,
. .
7. Matches familiarsbunds when stimulus changes (Activity).
(Uzgiris and Hunt, 1975, cited in Branston, Eng, Hunt &,Vincent, 1978)
Child will yepeat a similar sound in response to adult making a sound
from the child's repertoire, and change his/her sounds within 20 seconds
of adult changing the stimulus sound, for 80% of the trials on 2 'out of 3
consecutive days.
8. Imitates novel sounds directly.Ipi41-FiriFiaTag-Ti975, cited in Branston, Eng, Hunt & Vincent, 1978).
Child will imi*te a new sound (not in child's repertoire) within 20
seconds of adult modeling the sound, for 80% of the trials, on 2 out of
3'consecutive days, for a total of 5 new sounds. ,
9. Combines gestures and vocalizations (Activity).
Child will combine his/her vocalizations with appropriate gestures
with44 20 seonds of presentation of desired object or Verbal cue, for
80% of the trials, on 2 vt of 3 consecutive days.
10. Repeats most-simple new words.(Uzgiris and Hunt, 1975, cited in Branston, Eng, Hunt & Vincent, 1978)
Child will repeat one new word within 20 seconds of adult modeling the
word, for 80% of the trials, on 2 out of 3 consecutive days,'for at
least 5 new words.
143
III: EXPRESSIVE LANGUAgf Objectives (continued)
Says One - Three Words (AttivitY).
C i d will say-1 Word spontaneouslymithin 20 seconds of presentation
of an activity/object/person, on 2 out.of 3 consecutive days, for a
total of 3 words.
12.. NaMes'one familiar objett..Child will label 1 familiar object within 20 seconds of object presen-
1tation or verbal cue, for 80% of the trials,*on 2 out of 3 consecutive
days,.for at least 5 familiar objects.
13. Names picture of object.Child will label one picture of a familiar object within 20 seconds
of picture presentation or verbal cue, for 80% of the trials on 2 out
of 3 consecutive days, for at least 5 pictures of different oblbcts.
1 . Uses own name to'refer to self (ActiVity).
.Chtld will respond correctly with first name within 20 seconds of verbal
cue,"What 'is your name?" for 80% of the trials, on 2 out of 3 consecutive
days.
35. Says two - three word phfase.
, Child will use 1 two-three word phrase, on 2 out of 3 consecutive days,
for at least To phrases.
16. Uses pronoua (Activity).Child will use I pronoun, on 2 out of 3 consecutive days, for at least
3 pronouns.
17. Uses Past tense (Activity).Child will use 1 past tense verb, on 2 out,of 3 consecutive days for at
least'5 past tense verbs.
questionsansweronequeition-using a verbal or gestural response within
20 seconds of question being asked, for 80% of the trials on 2 out of 3
consecutive days, for at 1east-10 simple questions (e.g., "When",
"Where", "What"). e
19. Uses size words (Activity).Chilqwwill use a size word spontaneously, at least 3 times a day, for
2 outt-of 3 consecutive days.
20. Uses Plurals.thi1d will use one plural correctly within 20 seconds of presentation
.'of objects/pictures, for 80% of the trials, on 2 out of'3 conecutive
days, for at least 5 different sets of objects[pictures.
21. Uses one preposition.Child will use'a preposition correctly within 20 seconds of presentation
of _objects and'verbal cue, for 80% of the trials, on 2 out of 3 consecutive
days, for at least 3 different prepositions.
III. EXPRESSIVE L GUAGE: Objectives (continued)
22. Asks questioils beginning with "What", "Where", "When" (ActiVity).Child will ask at least 3 questions beginning with "What", "Wherea,"When"; Spontaneously.
I. VISUAL RESPONSE TO STIMULUS
Objective:
1. Child will'respond with one or more of the to:flowing:
a. glancing or looking at object
b. eye blinkc. cessation of activity
within 10 seconds of presentation of visual stimuli for 80% of the
trials on 2 out of 3 consecutive days.
2. Visually Follows; 900 .angle.
Child will.viSually follow an object continuously,from midline to side4
and/or side to midline within 20 seconds of:objectpresentation for 80%
of the trials on 2 out of 3 consecutive days.
3, y_isuallFollove.rh-i-TCiwiTEis-u-all-y-f-611-6-w-in object
continuously from side to side,
1800, within 20 seconds of object presentation for 80% of the trials
on 2 out of 3 consecOtive days.
4. Aitually follows; random motion.
Child will visually follow a continuously moving object which is moved
through a sequence of 3 different directionsrandomly, within 20 seconds
of object presentation for 80% of the trials, on 2 out of 3 consecutive
days.
II. OBJECT PERMANENCE - ACTIVITIES
Objective:
1. Finds a partially hidden object (Activity).
Child will uncover or pick up a partially coverednon-symmetrical object
within 20 seconds of object being covered for 80% of the trials on 2
out of 3 consecutive days.
2. Removes transparent obstacle (Activity)
Child will remove a transparent obstacle and obtain an object which is
within reach, within 20 seconds of obstacle being placed in front of
object for 80% of the trials on 2 out of 3 consecutive days.
3. Antici ates visually the trajectory of a slowly moving object (Activity)
d wi swat' is er g ance.. rom t e point o isappearance o an
object to the expected point of reappearance within 5 seconds of dis-
:appearance of Object for 80% of the trials on 2 out of 3 consecutive days.
4: Finds Hidden Object Under *a'Screen (Activity)
Child will find an objecthe/she sees hidden under one of three screens
within 20 seconds of object being hidden for 80% of the trials on 2 out
of 3 consecutive days.
5.* Follows trajectory of fast moving object (Activit )
- Child will vis'ually follow a rapid y moving or f&lling object after it
passes behind an obstacle for BO% of the trials on 2 out of 3 consecutive
days.
6. Finds hidden object under three superimposed screens.(Activity)
Child.will find an object he/she sees hidden under three layers of
screens placed one'at a tiMe On the Objedt, Within 20 seconds ofobject being hidden for 80% of the trials on 2 out of 3 consecutive
days.
7. Hidden Displacement (ACtivity)Child will find an object, when hidden by a seMes of displacements(hidden displacement), for 80% of the trials on 2 out of 3 consecutive
dan.
8. Functional Permanency (Activity).Child will search for an object where it was last ieen (at least 10 minutes
ago), or where it is usually kept, within 20 seconds of verbal cue for
80% of the trial& on 2 ott of 3 consecutive days.
III. MEANS-END/CAUSALITY
1-Objective:
1. Overcomes obstacle to obtain ob'ect ActivitChild will obtain an object by reaching over or around an obstacle
or by removing the barrier within 20 seconds of presentation of obstacle/barrier for 80% of the trials on 2 out of 3 consecutive days.
2. Retrieves object using other material (Activity).
Thi-ld will pull the material 'on which an object rests to obtain the
object, within 20 seconds of object presentation for 80% of the trials
on 2 out of 3 consecutive days.
3. Moves to obtain object that is out of reach (Activit ).
Child wi I move self to o tain an object that is out of reach (less than
5 feet away), but still visible, within 30 seconds of object being moved
for 80% of the trials on 2 out of 3 consecutive days.
4. Pulls string horizontally to obtain object (Activity).
Child will move self to obtain an object that is out of reach (less than
5 feet away), but still visible, within 30 seconds of object being
moved for 80% of.the trials on 2 out of 3 consecutive days.
5. Pulls string vertically to obtain object (Activity).Thild will pull upward on a string to obtain an object attached to the
string, within 20 seconds of object being lowered'beneath a/barrier
for 80% of the trials on 2 out of 3 consecutive days.
6. Uses tool to obtain desired object (Activity)
Child, will use an unrelated object to obtain a aesired object, within
30 seconds presentation of desired object for 80% of the trials on
2 out of 3 consecutive days.
7. Activation of toy (Activity). .
A. Child will hand toy to adult to reactivate; within 20 seconds oftoy ceasing its action.for 80% of the trials on 2 out of 3 con-secutive days.
B. Child will look for and succeed in activating a toy'(althotigh he/shedid not see toy activated) within 1 Minute of toy presentation for80% of the trials on 2 out of 3.consecutive days.
IV. MOTOR IMITATION
Objective:
1. Imitates familiar gesture.Child will make the same gesture within 20 seconds'of adult modelinga gesture from child's repertoire, for at east 5 familiar gestures,for 80% of the trials on 2 out of 3 consec tive "dlays.
2. Imitaies'a novel body movement that öhils can §ee hit/herself'perfOrm.Child will repeat modeled body action, thin 20 seconds of adUltmodeling a body movemedt, not in chili s repertoire, for at least 5novel body movements for 80% of th rials on 2"-out of 3 consecutivedays
3. Imitates "invisible" (facial) gestures.Child will make the qame facial gesture within 20 seconds 9f adultmodeling the facial gesture, for at least 5 facial gestures for 80%of the trials on 2 out of 3 consecutive days.
4. Imitates 2-action combinations,Child will repeat a 2-action combination within 20 s'econds of adultmodeling the actions, for at least five 2-action coMbinationsjor 80%of the trials on 2 out of 3 consecutive days.
5. Deferred imitation (Actiliity).
Child will repeat an action that was geen at least 10 minutes priorto the time the child performs the action for 80% of the trials op2 out.of 3 consecutive days.
V. SPATIAL RELATIONSHIPS
Objective:
1. Looks from ilne object to another (Activity).Child will look 6riefly at one object then another object when bothare held within his visual field, within 20 seconds of presdhtation
' of object for 80% of the trials on 2 out of 3 consecutive d4s.
2. Turns Object to "right side" (Activitx)Child grasps object, which has a definite front and backeor top andbottom, and turns it to the "right side", within 20 seconds of objectpresentation for 80% of the trials on.2 out of 3 consecutive days'.
3. Simple detour (Activity).Child will go around obstacles to obtain a desired object, within1 minute of losing desired object for 80% of the trials-on 2 out of3 consecutive days,
FINE MOTOR - Reach & Grasp
Objectives:
1.. Moves Arm Symmetrigally (Activity)child will move his/hercarms together with.random movements to the 5ide;
at least 2 times/within 20 seconds of object being prAsented in child's
visual field, for 80% of the trials on 2 out of 3 consecutive days. ,...
2. Brings'Aands to Midline in Supine PositionChild Will independently bri-iig (a) left, (b) right hand to a midline positfon
and hold this position for 3 seconds, within 20 seconds of foy presentatiOn,"
while lying on her/his back, for 80% of the trials on 2 out of 3 consecutive '
days.
3. Opens Hand, Indwelking Thumb No Longer Present (Activity)
Child will keep his/her hand open for at least 5 seconds with thumb no
longer held in his/her hand, within 20 seconds of phYsical proippt*, for
80% of the trials on 2 out of 3 consecutive days.'
4. Grasps Toy ActivelyChild will maintain his/her grasp on object using (a) left hand (b) right
hand, for at least 30 seconds, within ,20 seconds of object being placed in
child's hand; for 80% of the trials on 2 out Pf 3 consecutive days..
5. m_lcIToy_lp_aReachesTovithoutGrasin
Child will reach and touch object preSented at arm's length, at midline,
within 20 seconds of object presentation, for 80% of the trials on 2 out
of 3 consecutive days.
6. Clasps HandsChild will independently grasp her/his own hands at midline or play with
her/his fingers for at least 5 seconds, within 20 seconds of tap at elbows
or verbal cue, for 80% of the trials on 2 out of 3 consecutive days.
.7. Keeps Hands Open.80% of the Time (Activity)
Child will keep his/her hands open and not fisted at least 80% of 10 one-
minute trials on 2 out of 3 consecutive days.
8. Uses Palmer Gra'sp (Activity)
Child will gyesp an object against the palm without use of the thumb,
within 20 seconds of object presentation, for 80% of the trials 6n 2 out
of,3 consecutive days.
9. Reaches for Object Bilaterally, i.e., witivlboth arms
Child Oil] reach with both arms and grasp an object presented at arm's length,
at midline, within 20 secondspf object presentation, for 80% of the trials
on 2 out of 3 cdosecutive days.
10. Uses Radial Palmar Grasp (Activity) .
Child will grasp an object with her/his thumb, index and middle fingers
against her/his palm, within.20 seconds of object presentation, for*ta
of the trials, on 2 out of a consecutive days.
FINE MOTOR - Reach. & Grasp (continued)
11. Holds Arm Out When Antic.' atin !kin Picked U
C i d wil ift arms up at east inc es to indicatia-that s/he wants to
be picked up, within 20 seconds of verbal cue, for/80% of the trails on
2 out of 3 consecutive days.
12. Reaches for Ob'ect Unilaterall i.e. using ne arm-
Chi d will reac for object wit a left arm. I right arm and.grasp, an
object presented.at arm's length,. within 20 seconds of objeCt presentation,
for 80% of the trials on 2 out of,3 consgtutive days.
13. Approaches Second Object While Still Holding_ First ,(Activity.1
Child will reach for second object.while holding first object, within
20 seconds of presentation of second object, for 80% of the trialsr on
2 out 6f 3 consecutive days.
14. Attempts to Secure Tiny Object (Activity)
Child will attempt to grasp a pellet-sized-object from table/floor, within
20 seconds of objeCt presentation, for 80% of the trials on 2 out of 3
consecutive days.
15. Reaches and GratpObjectt crossing midline
Child will reach across midline with (a) left hand (b) right hand, and
,grasp object presented 450 from mi.dline to the side, within 20seconds
of object presentation, for 80% of the trials on Z out of 3 consecutive '
16. Rakes Tiny ObjectChild will pick up a tiny object using a raking motion within 20 seconds
.of object presentation, for 80% of the trial-s on'2 out of 3 consecuticte
glays.
17. Uses Radial Digital Grasp (Activity) ,
Child will grasp an object with the thumb, index and middfd finger with=
out the usd of the palm, within 20 seconds of object presentation, for
80% of the trials on 2 out of 3 consecutive days.
18. Uses Inferior Pincher Grasp (Activity)
Child will grasp a small object with her/his index finger and thumb (thumb
is positioned at the lateral or lower part of the index finger), withi6,20
secOndS of object presentation, for 80% of the trials, on.2 out,of 3
consecutive days.
19. Uses Neat Pincer GrasEChild will independently pick up one tiny object using a pincer grasp
within 20 seconds of Object presentation for 80% of the teials on 2 out
of 3 consecutive days..
-4
15t)
FINE MOTOR - Object Manipulation
Objective:
1. Begins Play with Rattle/Toy:
Child will shake or appropriately manipulate toy at least 3 times within
20 seconds of being given the toy for, 80% of the trials on 2 out of 3
consecutive days.
2. Holds an Ob'ect and Brin s It to Mouth,.
Child will hold an object and bring it to mouth, within 20 seconds of object
presentation, for 80% of the trials on 2 out of 3 consecutive days.
3. Use Hands and Mouth for Sensor Exploration of Ob. cts Activit
Child will manipulate an object using at least 2 d fferent actions within
5 minutes ofobject presentation, for 80% of the trials on 2 out of 3
consecutive days.
4. Regards Tiny Object (ActiVity)
T e c 1, oo s at an o ject,t e size of a pellet raisin for 1 second withim
20 seconds ofobject presentation, for 80% of the trials on 2 out of 3
consecutive days.
5. Looks at Distant Object (Activity)
Child will look at an object that is at least 5 feet from child, for at
least 1 second, within 20 seconds of verbal cue or object presentation,
for 80% of the trials on 2 out of 3 consecutive days.
6. Picks Up Dropped Object
Child will pick up an object that is anywhere within reach using (a) left
c hand; (b) right hand, within 20 seconds of object being presented or dropped,
fOr 80% of the trials, on 2 out of 3 consecutive days.
7. Retains Small Object in Each Hand
Child will hold a small object in each hand simultaneously for at least
10 seconds, within 20seconds of toy presentation, for 80% of the trials
on 2 out of 3 consecutive days.
8. Transfers ObjectChild will grasp an object with one hand then transfer the object to the
other hand, within 20 seconds of the cnd object being offered, for 80% of
the trials on 2 out of 3 consecutive days.
9. Bangs Object on Table (Activity)
Child will bang/hit an object on a table or any hard surface at least
3 times within 20 seconds of object presentation, for 80% of the trials
on 2 out of 3 consecutive days.
10. Mani ulates To Activel with Wrist Movements Activit
The child grasps, explores and manipu ates a toy using at least 3 active
rotary wrist movements, within 20 seconds of object presentation, for
80% of the trials, on 2 out of 3 consecutive days.
0%.
Fine Motor - Object Manipulation (continued)
11. Elarisl'ojithertP-Ta will bang/hit 2 objects together at least 3 times within 20 seconds of
having the 2 objects in her/his hands, for 80% of the trials, on 2 out of
3 consecutive days.
12. Removes Pegs From Pe9board
Child will take 5 small'pegs out of a pegboard independently within one
minute of presentation of pegs, for 80% of the trials on'2 out of 3
consecutive days,
13. Extends Wrist (Activity)
Child will extend her/his wrist whilemanipulating objects within one minute'
of object presentation, for 80% of the trials, on 2 out of 3 consecutive days.
14. Takes Objects Out of Container (Activity)
Child empties or removes at least 3 objects from a container by dumping it
over or by taking out the objects one by one, within one minute of container
presentation, for 80% of the trials on 2 out of 3 consecutive days.
15. Pokes with Index Finger (Activity)
Child will isolate her/his index finger to poke or feel an object within
20 seconds of Verbal cue or object presentation, for 80% of the trials,
on 2 out of 3 consecutive days.
16. Puts Object into Container
Child will place at least one small object into a small container, within
20 seconds of verbal cue or presentation of objects, for 80% of the trials,
on 2 out of 3 consecutive days.
17. Stack RingsA) Child will remove 6 rings from a ring stack, within one minute of verbal
cue or presentation of rings, for 80% of the trials, on 2 out of 3
consecutive days.
B) Child will place 6 rings on a ring stack in any order, within one minute
of verbal cue Or presentation of rings, for 80% of the trials, on 2 out
of 3 consecutive days.
18. Places at Least 6 Round Pegs in Pegboard.
Child will place at least 6 round pegs in a pegboard, within one minute
of verbal cue or presentation of pegs, for 80% of the trials, on 2 out of
3 consecutive days.
19. Places Circle, Square, Triangle Shapes into Form Board
When presented with a form board with a circular hole, a square hole, and
a triangular hole, child will independently place the 3 shapes (circle,
square, triangle) into the appropriate holes, within one minute of presentation
of the shapes, for 80% of the trials, on 2 out of 3 consecutive days.
20. Builds Tower Using 8 Cubes
Child will build a tower of 8 cubes, placing one cube over another, within
2 minutes of verbal cue, or presentation of blocks, for 80% bf the trials,
on 2 out of 3 consecutive days.
Fine Motor - Object Manipulation (continued)
21. Strings 3 One-inch Bead (ctivity)Child will string at least 3 one-inch beads with a heavy corded string, within
5 minutes of presentation of beads, for 80% of the trials on 2 out of 3
consecutive days,
22. Puts Tiny Object into Small Container
Child will place at least one tiny object into a small container, within
20 seconds of verbal cue or presentation offobjects, for 80% of the trials,
on 2 out of 3 consecutive days.
23. Snips with Scissors (Activity)
Child will make at least 3 discreet snips with the scissors, within one
minikte of verbal cue and presentation of materials, for 80% of the trials
on 2 out of 3 consecutive days.
24. Imitates Adult drawing lines, circles, crosses
Child will imitate the following strokes within 20 seconds of adult modeling
the stroke; for 80% of the trials on 2 out of 3 consecutive days.
25. Places 6 Square Pegs in Pegboard.
Child will place 6 square pegs in a pegboard, within 2 minutes of verbal
cue or presentation of pegs, for 80% of the trials, on 2 out of 3
consecutive days.
26. Completes (A) Non-interlocking puzzle (B) Interlocking Puzzle.
(A) Child will independently complete a five piece non-inter)ocking puzzle;
for 80% of the trials, on 2.out of 3 consecutive days%
(B) Child will complete 3-4 piece interlocking puzzle, for 80% of the trials,
on 2 out of 3 consecutive days.
27.'Stacks Rings in Correct Order (Activity.1
Child will independently stack at least 6 rings in the correct order,
within 5 minutes of presentation of ring stack, for 80% of the trials,
on 2 out of 3 consecutive days
28. Imitates Three Block Bridge usin9 cubes (Activity)
Child will build a bridge using three cubes (one-inch) within one minute
of adult modelling the bridge for 80% of the trials, on 2 out of 3 con-
secutive days.
15j
Pre-Academics
I. DISCRIMINATION
A. Matching.
Objectives:
1. Matches ObjectsWhen presented Viith a choice of 3 different objects (target object, 2 dis,
tractor objects) child will correctly point to or touch the object that
matches the target object, within 20 Seconds of verbal cue, "Find the one
that's the same", for 80% of the trials, on 2 out of 3 consecutive days.
2. Matches Sounds to Animals (Activity)
A. Child.will vocalize correct sound, within 20 seconds of question,
"What does the (animal) say?", for 80% of the trials, on 2,out of
3 consecutive days; for.at least 5 animals.
B. Child will point to correct animal (for a choice of 3) within 20
seconds of question, "What goes (animal sound)?", for 80% of the
trials, on 2 out of 3 consecutive days; for af least 5 animals.
3. Matches Objects to PicturesWhen presented with a choice of : a) 3 different objects (1 target object,
2 distractor objects), child will correctly point to or touch the object4
that matches the target picture, within 20 seconds of the verbal cue,
"Find the one that's the same", for 80% of the trials, on 2 out of 3
consecutive days.
When presented with a choice of : b) 3 pictures of different objects
(1 target picture, 2 distractor pictures), child will correctly point
to or touth the picture that matches the target object, within 20
seconds of the verbal cue,."Find the one that's the same", for 80% of
the trials, on 2 out of 3 consecutive days.
4. Matches Sounds to Pictures of Animals (Activity) .
A. Child will vocalize correct sound, within 20'seconds of question
"What does the (animal) say?", for 80% of the trials, on 2 out of
3 consecutive days; for at least 5 animal'picture.
B. Child will point to correct animal picture (from a choice of 3),
within 20 seconds of question "What goes (animal sound)?", for
80% of the trials, on 2 out of 3 consectuive days; for at least
5 animals.
5. Matches Shapes - Circle_,_ Triangle, Square (Toys) .
When presented with a circular shape, a triangular shape and a'square
shape, child will correctly point to or touch the shape that matches
the target shape, within 10 seconds of the verbal cue, "Find the one
that's the same," for 80% of the trials on 2 out of 3 consecutive days.
15 i
Pre-Academics
I. DISCRIMINATION
A. Matching - continued
6. Sorts ObjectsChild will sort at least 20 objects into 4 groups, each group/set
containing at least 5 identical objects, within 5 minutes of verbal
cue, "Sort the ", for 80% of the trials on 2 out of 3 consecutive
days.
7. Matches Identical Simple Pictures of Objects
When presented with a.choice of 3 pictures of different objects (target
picture, 2 distractorpictures), child viil correctly point to or touch
the picture that matches the target picture, within 20 seconds of verbal
cue, "Find the one that's the same, for 80% of the trials, on 2 out of
3 consecUtive days.
8. Sorts PicturesChild will sort at least 20 pictures into 4 groups, each group/set
containing at lea4st5 identical pictures, within 5 minutes of verbal
cue, "Sort the ", for 80% of the trials, on 2 out of 3 consecOtive
days.
9 Matches Prfmary Colors, and Black ahd'White
When presented with 3 colors, child will correctly point to or touch the
color that matches the target color, within 20 seconds of the Verbal
cue, "Find the one that's the same", for 80% of the trials, on 2 out
of 3 consecutive'days.
10. Matches Similar Pictures of Objects
When presented with at least 20 pictures (4 object sets, with 5 similar
pictures of the same object in each set); child will sort the pictures
into 4 sets of pictures of the same object, within 10 minutes of the
verbal cue, "Find all the pictures of ", for 80% of the trials, on
2 out of 3 consecutive days-.
11. Sorts Shapes - Circle, Triangle, Squarewill sort at least T5 shapes into 3 sets, each set containing
at least 5 similar (but not identical) shapes, within 5 minutes of
verbal cue, "Sort the ", for 80% of the trials, on 2 out of 3
consecutive days.
12. Matches Pictures of Shapes .
When presented with a choice of 3 pictures of different shapes (1 target
shape, 2 distractor shapes), child will correctly point to or touch
the shape that matches the target shape, withtn 20 seconds of verbal cue,
"Find the one that's the same", for 80% of the trials., on 2 out of
3 consecutive days.
13. Sorts Colors1471-i&t at least 20 objects into 4 sets, each set containing at least
5 objects identical except for color within 5 minutes of verbal cue,
"Sort the ", for a total of 6 different colors, for 80% of the
trials, on 2 out of 3 consecutive days.
t
r: DISCRIMINATION
, B. piscrimination
Objectives:, ,
1. . Looks for Family 'I'llembers or Pets When Named; Recognizes Several People in
Addition to Immediate Family.Child will .identify named person by looking toward or pointing to the
person within 20 seconds of verbal cue, for 80% pf the trials, on 2 out of
3 cohsecutive days; for at least 3 family members and 2 people in addition
to immediate family. . .
2. Discriminates Objects.
/When presented with a choice of 3 objects (a target obj ct and 2 distractor
objects),-child will correctly point to or touch the t get object within
-20 seconds of the verbal cue, PFind the ,",for 80% of the trials on
2 out of 3 consecutive days, for a total of 10 objects.
3. Indicates Two Objects From Group of Familiar Objects (PrAivity). ..,
-Child will point to, touch, or pick up two different objects at the4isame time
out of a group of three to five objects within'20 seconds of verbal cue, for
80% of the trials, on 2 out of 3 consecutive days.
1 4. Identifies Self. .
Child will identify self by pointing to self or mirror image,,within 20
seconds of verbal cue, for 80% of the trials on 2 out of 3 Consecutive days.
5. Idehtifies at Least 6 Body PartsChild will identify 1 body part on self/doll by pointing or touching the part
named, within 20 seconds of verbal cue, for 80% of the trials on 2 out of 3
,
consecutive days; for a total of 6 body parts.
6. Brings Objects from Another Room on Request (Activity),
Child will bring an object from another room within 1 minute pf verbal cue,
for 80% of the trials, on 2 out of 3 consecutive days; for a total of 5 objects.
7. Recognizes and Points to,Animal Pictures.'. .
When presented with a choice of 3 animal pictures (1 target picture, 2 distractor,
pictures), child will correctly point to or touch the target pictures within
20 seconds of verbal cue, "Find the (target animal)", for 80% of the trials bn
2 out of 3 consecutive *days. ,
'
.
8. Points to Distant Objects Outdoors.(Activit,0.
Child will point in direction of named object, within 20 seconds of,verbal cue,
for 80% of the trials, on 2 out of 3 consecutive days; for at least 5 objects.
9. Points to Several Clothing Items on. Request.When presented with a choice of 3 pieces of clothing (1 target, and 3 dq.-
tractors), child will correctly point to or touch the target clothing within
20 seconds of the verbal cue, "Find the (target clothing)", for 80% of the
trials on 2 out of 3 consecutive days.
156
I. DISCRIMINATION'BDiscrimination conttnued
10. Recognizes Self in P4tograph (Activity).
When presented with a choice of 2.photographs, child will point to or pick
her/his-own photograph within 20 seconds of verbal cue, "Find (target object)",
for 80% of the trials on 2 out of 3 consecutive days.
11.. Find Her/His Own Belongings From Others (Activity).
When presented with a choice of 3 sets of belongings (e.g., clothes, shoes),
child will corl-ectly pick.out her/his own withirr 20 seconds of verbal cue,
"rind yOur. (target object)," for 80% of the trials on 2 out of 3 consecutive
days.
12. Points to Pictures of Familiar Ob'ects and Peo.le i.e. Discriminates
Pictures of Objects and People.when presented with a choice of pictures of 3 different objects of people
.(a target picture and 3 distractor pictures), child will correctly point
'to,or touch the target picture within. 10 seconds of verbal cue, "Find the
(target object)", for 80% of the trials on 2 out of 3.consecutive days.
13. Identifies Rooms in Own House (Activity).
Child will go to or point to a room in her/his house, within 1 minute of verbal cue
for 80% of the trials, on 2 out of 3 Consecutive days; for at least 3 different mon
14 Identifies Clothing_ilmisforsgifferent_Occasigas_(Activity).When presented with a choice of 3 clothing,items, child will pick out
appropriate clothing within 20 seconds of verbal cue: "What do you wear when
you ?", for 80% of the trials on 2 out of 3 consecutive days.
15. Recognizes Familiar Adult in Photograph (Activity).
When presented with a choice of 3 photogr'aphs, child will point to correct
picture within 10.seconds of verbal.cue "Find (adult's name)", with 80%
accuracy, on 3 consecutive days.
16. Understanding of Prepositions.Within 20 seconds of the cue "Put/Take the object preposition the container/
furniture, the child will pick the object up and place it in the correct
position, for 80% of the trials, on 2 out of,3 consecutive days.
17. Selects Pictures Involving Action Words.
When presented with a choice of 3'action pictures, child.will point to
correct picture within 20 seconds of verbal cue, "Show me the girl/boy
", for 80% of the trials on 2 out of 3 consecutive days, for at least
5 action pictures.
18. Knows Own Sex of Others_SActivity).
When presented with 2 choices, child will pick out the girl/boy within
20 seconds of verbal cue "Which one is a (girl/boy)?", for 80% of the
trials on 2 out of 3 consecutive days.
15'
I. DISCRIMINATIONB. Dischmipation - continued
19. Identifies Familiar Objects by Touch (Activity).
When presented with a choice of 3 objects fhat are covered, child will find
-the correct object by touchjng, within 20 seconds of verbal cue, "Find the
", for 80% of the trials on 2 out of 3 consecutive days; for at least
5 objects.'
20. Discriminates Several Colors.
When presented with a choice of 3 pictures.of identical objects except for
color (1 target color, 2 distractors), child will correctly point to or
touch the picture of the target color, within 20 seconds of the verbal
cue, "Find the (target color)(object name)," for al of the trials on
2 out of 3 consecutive days;'for at least 5 colors. -
-21. Discriminates 3 Shapes.
When presented with 3, objects identical except for shape (1 target shape,
2 distractor shapes), child will coy'rectly point to or touch the target
..shape, within 20 seconds of verbal cue; for 80% of the trials on 2 out of
3 consecutive days; for a total of 3 shapes.
1
6
Pre-Academics....
II. CLASSIFICATION
A. Function
. :#1 Demonstrates Use of Objects
42 Identifies Objects With Their Use
B. Attributes
#1 Understands Concept of One
#2 Gives. One Out,of Many
#3 Points to Larger or Smaller of 2 Objects
114Understands Concept of Two
,-
#5 Points to Longer of 2 ObjeCts
... -..#6 Points to Longer of 2 Lines ,
,.
-
_ -
,
15,)
%.
..
_
,
III
,
,
)
Pre-Academics
II. CLASSIFICATION
. A. Function
'04'
Objectives:
Demonstrates Use of Obj.ects
Child will demonstrate.functional use of 1 object, using appropriate
gestures, within 20 seconds of verbal -cue, "What do you do with ?"
for 80% of the trials on. 2 out of 3 consecutive days; for at least
10 objects.
2. Identifies Obiests With Their Use.
5en presented with a choice of 3 objects, child will pick out correct
object, within 20 seconds of verbal cue "What do you (function)?" for
80% of the trials on 2 out of 3 consecutive days; for at least 5 objects.
B. Attributes
1.UndersTands Concept of One.Child will point fo a set of one out of a choice of 3 sets, within
20 seconds of verbal cue, "Find one " for 80% of the trials
for 2 out of 3 consecutive days.
2 Gives One Out of Many (Activity)
When presented with at least 5 objects', child will pick out one
within 20 seconds of verbal cue, "Get one (object name)" for 80%
of the trials on 2 out of 3 consecutive days.
3. Points to Larger or Smaller of 2 Objects
When presented with 2 objects that are identical except for size,
child will point to the correct object within 20 seconds of Verbal
cue, "Find the Small (object name)" for 80% of the trials on 2 out
of 3 consecutive days.
4. Understands Concept of Two
Child will point to a set of 2 out of a choice of 3 sets, within 20
seconds of verbal cue, "Find 2 (object name)" for 80% of the trials
on 2 out of 3 consecutive days.
5. Points to Longer of Two Objects.(Activity)
When presented with 2 objects, child will point to the longer of the
objects, within 20 seconds of verbal cue "Find the longer (Object
name)" for 80% of the trials on 2 out of 3 consecutive days.
6. Points to Longer of Two Lines (Activity)
When presented with 2 lines, child will point to the longer of the
lines,-within 20 seconds of verbal cue, "Find the longer line", for
80% of the trials on 2 out of 3 conseCutive days.
SOCIAL CURRICULUM (Activities and Objectives)
1. Ressonds To Another Person ActiVit )
1 a wi c ange s her e avlor by increasing activity, turning head,
or visually following people around him/her within 20 seconds of social
contact for 80% of the trials on 2 out of 3.consecutive days.
2; Regards Face_(Activity)The child will momentarily look at the face of the person interacting with
him/her within 20 secondkof presentation of person's face for 80% orthe
trials on 2 out of 3 consecutive days.
3. Illaleslye Contact With An Adult
The thild will establisFiria-iiii-intain eye contact with an adult for 5 seconds
within 20 seconds of verbal cue, 1"['child's name'], look at me",for 80% of the
trials on 2 out of 3 consecutive Ciays.
4. Vocalizes in Response To Adult Talk and Smile (Activity)
.The-child will vocalize, coo, or make happy sounds within 20 seconds of"
presentation of adult smiling and vocalizing, for 80% of the trials on
2 out of 3 consecutive days.
5. Smiles At'Mirror Image (Activity)
The child will smile at image of self in mirror within 30 seconds of
presentation of mirror, for 80% of the trials on 2 out of 3 consecutive
days
6: Responds To Own NameThe child will turn toward a person calling his/her name from a distance
of 5 feet within 10 seconds of verbal cue, for 80% of the trials on 2 out
of 3 consecutive days.
7. Repeats Social*Game Activity (Activity)
Teci wi 1 respon appropriateyfo an adult inagame pf peek-a-boo
or pat-a-cake and gesture for game activity to be repeated within 20 seconds
of cessation of game, for 80% of the trials on 2 out of 3 consecutive days.
8. Gives Toy On RequestThe chi)d will give toy to familiar adult withia 20 seconds of adult request,
for 80% of.the trials on 2 out of 3 consecutive days.
9. Child Plays Beside Or In Close Physical Proximity With Another Child (Activity)
he c 1 wi p ay esi e or in ess t an two feet from another child for at
least 10 minutes, for 80% of the trials on 2 out of 3 consecutive days.
10. Child Initiates Inde endent Pla Task But Re uired Adult Su ervision To Carry
ut Ideas ActjvityThe cbild will initiate task play (alone or with others) for at least 10
minutes, but may require adult.supervision for 80% of the trials on 2 out
of 3 consecutive days.
11. Partictpates In Circle Games (Activity)
The child will interact with other children in circle games such as "Ring
Around The Rosie", and "The Farmer In The Dell", for 80% of the trials the
task is introduced on 2 out of 3.consecutive days.
1 6
0-
11
I.4
fcl
,
Appendix C,
,
Individualized Education Program Form
16,-,'
1.
3
San FrancisCo Infant Pro ram-
Indivtdualized Educational-Program
1. Name:.Age: B.D.:
A2. Medical Considerations and.Physital DescriptiLon
3. Mode of Communication:
4. Dehioral Characteristics:
5, Effective Reinforcers:
6. Interactions with Non-Handicapped Peers:
7 Servides:
ServicesInitiation Date Duration Personnel
Conference Attended By:
Parent
Parent
Other
Date TeacherDate
Date Therapist
Date
Date
Other-,..
Date
Long-Term Goal:
Short-Term ObjectiyesAnticipated
Instructional and/or . Date ofTeaching Strategies Completion
ASMFPWrOMMrnalrfr0a004Vela
Method ofMeasurement
RelatedAreas'of Concern
1(3i
.
,,
Appendix D
Parent Participation Formis
1) Program Development Sheet
2) Data Sheet
3) Parent Involvement Plan
e
,
San Francisco Infant Program
Name: Date:
Objective:
Materials:
Procedure:
Additional Objectives:
Additional Suggestions:
Suggeste'd Ideas for Observation:
Any Questions?
1 G c.)
APPENDIX IVgown's Syndrome Infanf-Parent Program* -
TARGET SKILL:
Appendix/221
Week 1 Week 2
Date/ / / / / / / / / / / /10 10 10 10 10 10 10 10 10 10 10 10 10 10
9 9 9 9 9 9 9 9 9 9 9 9 9 9
8 8 8. 8 8 8 8 8 8 8 8 8 8 8
7 7 7 7 7 7 7 7 7 7 7 7 7 7
6 6 6 6 6 6 6 6 6 6 6 6 6 6
5 5 5 5 5 5 5 5 5 5 5 5 5 5
4 4 4 4 4 4 4 4 4 4 4 4 4 4
3 3 3 3 3 3 3 3 3 3 3 3 3 3
2 2 2 2 2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1 1 1 1 1
0 0 0 0 0 0 0 0 0 0 0 0 0 0
NOTES:
Week 3 Week 4
Date /10 10 10 10 10 10 10 10 10 10 10 10 10 10
9 9 9 9 9 9 9 9 9 9 9 9 9 9
8 8 8 8 8 8 8 8 8 8 8 8 8 8
7 7 7 7 7 7 7 7 7 7 7 7 7 7
6 6 6 6 6 6 6 6 6 6 6 6 6 6
5 5 5 5 5 5 5 5 5 5 5 5 5 5
4 4 4 4 4 4 4 4 4 4 4 4 4 4
3 3 3 3 3 3 3 3 3 3 3 3 3 3
2 2 2 2 2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1 1 1 1 1
0 . 0 0 0 0 0 0 0 0 0 0 0 0 0
NOTES:
Adapted from Saunders, R. R. 1. Koplik, K. A multi-purposedata sheet for recording and graphing in the classroom. AAESPHRevive. 1975, 1, 1-8
This data sheet appears .inHanson, M. J. Teaching your Down'sSyndrome infant: A guide for parents.
Baltimore, Maryland: Uni4ersity Park
Press, 1978. -
1
1
4,
PUPILIIAME
SCHOOL
il
k1Lli!..iNU EARLY CNIINIUM EDUCAlIWI Pk0f;RAM (REIMPARENT INVOLVEMENT PLAN (PIP)
PARENT/GUARD1AN
ADDRESS
PHONE
SPECIAL EDUCATION PROGRAM 0
0,
PIP MEETINGPIP BEGINS ONREVIEW ,
DAUS
3YEAR ASSESSMENT BY:
AREAS OF NEED: PARENT SIGNATURE, .
TEACHER SIGNATUREEDUCATIONALI.
SERVICES:POSITIONING
2. CARRYING3. MOTOR S'XILtS:
c
4. HAND USE/MANIPULATION5. LANGUAGE EXPRESSIVE6. LANGUAGE RECEPTIVE
7. SENSORIOTOR /
8. FEED1NG/PRE-SPEECH9. BATHING
10. DRESSINGII. TOILETING12. HANDWASHING13. PLAY
14. BEHAVIOR MANAGEMENT15. SPECIFIC STRATEGIES FOR TEACHING
(SPECIFY CURRICULUM AREAS)1.
2.
3.
4.
REFERRALS FOR RELATED SERVICES:I. SOCIAL SERVICES ASSISTANCE2. RESPITE OR CHILD CARE3. TRANSPORTATION4. MEDICAL OR DENTAL5. FAMILY COUNSELING
LIST OF ANNUAL GOALS FOR PARENT PARTICIPATION
CAN BE FOUND ON PAGE 2
..;
A,
DATE: .
..
PARENT/STAFF:
STUDENT:
LEARNING AREA:
ACTIVITY:
INSTRUCTOR/RATER:
RECO .:: . ..
PARENT/STAFF TRAINING FORM
KEY: RATINGS:
B . baseline I.,
I . intervention
F . follow-up
t
No correction necessary. ,
2. Verbal suggestion only
3. Verbal suggestion with some physical
correction
4. Necessary to retrain technique
7)
RATING
SEQUENCE OF BEHAVIORS
_
: Colt:2'S POSITION'
II ADULT'S POSITION
1
III ANTICIPATED RESPONSE
NAME
KEY
DATE
,
)
-
Appendix.E
Student Thesis
TEACHING MOTOR SKILLS TO TWO SEVERELYHANDICAPPED INFANTS - A COMPARISON OF APPROACHES
A thesis submitted to the faculty ofSan Francisco State University-in partial fulfillment of the
requirements for the '
degreeMaster of Arts
by
MARGARET ANN VELTMAN
San Francisco, California
September, 1981
CERTIFICATION OF 'APPROVAL
I certify that I have read TEACHING MOTOR SKILLS TO
TWO 'SEVERELY HANDICAPPED INFANTS - A COMPARISON OF
APPROACHES by Margaret Ann Veltman, and that in myopinion
this wOrk meets the criteria for approving 'a thesis sub-
mitted in partial fulfillment of requirements for the
Master of Arts degree at San Francisco State University.
35171 J. Hanson, Pg:57-Ledturer, Department ofSpedial Education
Wayne S. Sailor, Ph.D.Chairman, Department ofSpecial Education'Severely MultiplyHandicapped
Norm Wallen, Ph.D.Chairman, Department ofSpecial Education
1 '7,,
'16
TABLE OF CONTENTS
page,-
LIST OF TABLES
LIST OF__FIGURESII
CHAPTER I: Introduction
CHAiTER II: Review of'the Literature
1
6
CHAPTER III: Methods and Procedures 21
Subjects 21
Setting b23-
Learning/ Equipment ,23
.Experimental Design 24
Independent Variable 25
Dependent Variables 26
. Experimental Phases 27
Exkerimental Procedures 29
Data Collection and Analyses 30
Reliftbility30
CHAPTER IV: Results 31
Motor Response and Approximations .31
Visual Fixation, Smiling and Vocalizations 34
Fussing and Crying 34
State. of Arousal47
Reliability50
CHAPTER V: Discussion 51
BIBLIOGRAPHY57
.APPENDICES64
1. parental Consent Form65
2. Diagram of Classroom 67
3. Brazelton's'States (Adapted) 69
4. Pilot Procedures71
5. Pretest Procedures74
6. Treatment 1 Procedures77
7. Treatment 2 Procedures 80
8. Diagrams of Learning Equipmeni:Weight Bearing
84
Weight Bearing Wiring. 85
Bilateral Reach/Grasp86
Bilateral Reach/Grasp Wiring 87
0
LIST OF TABLES'
1. State of Arousal -Subject 1 48
2. State of Arousal -Subject 2 ... .. 49
0
ii
a LIST OF FIGURES
1. Multiple Baseline Data Graphs
Motor Responses - Subject 1Approximations - Subject 1Motor Responses - Subject 2Approximations - Subject 2Visual Fixation - Subject 1
- Subject 2
Page,
323335363738
Smiling - Subject 1 39- Subject 2 40
Vocalizations - Subject 1 41- Subject 2 42
Fussing - Subject 1 .... . 43Crying -.Subject 1 44Fussing - Subject 2 45Crying - Subject 2 46
/2. Classroom Layout (in Appendix 2) 67 .-
3. Experimental Procedures (in Appendices 4,5, 6, and 7)
- Pilots 71
Pretests ° .74
Treatment 1 ,- 77Treatment 2 ..... . 80 -
4. Learning Equipment (in Appendix 8)
Weight Bearing . ... 84Weight Bearing Wiring ... ...... 85Bilateral Reach/Grasp .. .... 86Bilateral Reach/Grasp Wiring 87
-.,
CHAPTER I.
Introduction
The early responses of infants reflect their
efforts to explore and control their environments. The
more opportunities children have to test behavior, ihe
more liYely they are to modify their own actions and
cope with their surroundings. The predominate concern for
handicapped infants is that they too are provided with
experiences which will result in satisfying interactions
(Conner, Williamson, and Siepp, 1978).
Severely handicapped infants may have severely
limited behavioral options. Under such circumstances,
successful environmental transactiOns must necessarily
be facilitated, or exaggerated, enabling infants to
identify relationships between events.
Cause and effect, or contingent relationships
imply that actions are ccditional; that they control or
are controlled by other actions. Active participation in
deciphering contingencies is an inherent prerequisite to
learning, and it is a continual process, requiring
increasingly complex manipulations of our Anvironmerits.
Since intellectual competence is largely detetmined by the
fability to deduce an outcome from prior experienc s,, the
1
2
condition or status of an organism is partially dependent
upon the extent to which these action-pairings are
realized. Under normal circumstancds, the organism
enco1nter3 contingent situations repeatedlys Once
relationships between actions are understood, behavior can
be elicited predictably, and according to need. Thus,
through exposure, experience, and modification, we learn
to manipulate our environment 1/ effectively.
The behavioral school of thought postulates that
learning is primarily the result of the interactions an
organism engages in with extrinsic environmental elements.
Developmentalists maintain that these experiences are
essential to higher cognitive functions. Piaget, an
interactionalist, describes the experiences in terms of
normal maturational occurrences in the sensorimotor
stages of development, (the period from birth to two years
of age). He outlines the infant's progressive inter-
actional initiations beginning with purely reflexive
actions, followed by a preoccupation with the actions4
themselves, to a rudimentary, and finally, a functional
understanding of the means-ends'relationship.
How we incorporate feedback from our environ- .
ments and how well we learn to use this information to
further control over our changing surroundings only
becomes an issue when.the process is se Alow interrupted.
Under severe, physical handicapping conditions, inter-
actional initiations, in particular, those subtly emitted
3
by the infant, may not be detected by the environment.
In unresponsive surroundings,.the orportunity to derive
cause and effect information is restricted, possibly
impeding higher learning. Special educators have
developed curricula for the school-aged segment of this
population to insure feedback for specific responses.
The majority of these programs follow an operant paradigm,
whereby the student is typically both cued and rewarded or
reinforced for a targeted behavior. Interactions are
monitored and cOntrolled. These techniques have gained
increased popularity in the area of severely handicapped
because of their effectiveness in facilitating skill
acquisition. They are not, however, always appropriate
for use with infants who may habituate (show a response
decrement to repeated presentations of a stimulus), pass
through different states of arousal, require short
latency periods for reinforcement, and move in increments
that cannot always be assessed with relative accuracy.
Prosthetic devices have also been employed with
school-aged and older severely handicapped people. Some
offer assistance through providing the individual with
personal or bodily adaptations, (artifical limbs, pointing
devices, splints, etc.). Others facilitatezresponding via
adaptation or arrangement of the environment. Examples of
these are seating and standing equipment,for static
positioning and inflatables (swim rings), for encouraging
dynamic or active responses (Kasari and Filler, 1981). A
18i
4
subcategory of the latter group include 'actual manipu-
landa, or learning devices, which may detect, measure
and/Or consequate a given behavior. It is unfOrtunate
that the consequence, in order to be reinforcing for older
severely handicapped persons, is often not functionally
related to the targeted response thus creating a
contrived situation.
Though advances continue-to be made in these
areas, the crucial time to intervene is when interaction
naturally begins, in infancy. Since an individual
theoretically formulates cause and effect relationdhjps
from feedback s/he receives as a result of actin,g upon
the environment, prosthetics alone do not constitute an
adequate remediation. Curricula designed for older
children, unless modified in light of issues specific to
infancy, would likewise be inappropriate. The severely
handicapped infant who is physically impaired mUst be
given every opportunity to initiate interactions with the
environment through normal channels. A device sensitive .
enough to detect Minute motoric changes and efficient
enough to provide contingent reinforcement within a
specific latency period, may provide the optimal
conditions for an exchange to occur. The training of
functional motor responses, consequated by naturally
ensuing phenomena, when possible, may enhance further
initiations, exploration and learning in this tradition- 4
ally difficult population.
18>
.. 5
From a theoretical standpoint, understanding
cause and effect relationships is prerequisite to higher
cognitive processes. The possibility exists, then, that
the failure to learn under severe handicapping conditions
may at least be partially due to an inability to establish
these relationships. Learning devices may provide the
vehicle by which such information is gained.
The purpose of this investigation was to
.1) measure the efficacy of employing 1 arning devices
to teacl- functional motor responses, and 2) foster the
understanding of cause and effect, relationships in
severely handicapped infants. This method was compared
to a therapeutic approach, currently the standard inter-
vention strategy used in 'many infant programs, whereby
the physical or occupational therapist directs or
provides "hands-on" motor training:
CHAPTER II
Review of the Literature
"A major form of' mythology about infancy has
been that the infant, especially during the neonatal
period, is an incomplete, relatively incompetent and
inadequate organism; and that by a series of linear
progressions, the infant becomes a complex, competent,
and complete organism - an adult. Such a vtew is a
logical and emotional heritage of the supposedly dis-
carded notion that the infant i a miniature adult with
a tabula rasa, helpless and passive, dependent on an
imprint from the mature caretaker who provides a model
for limitation and a stimulus for.learning adult modes
of thinking and behavior." (Thoman, 1979). Research
findings, however, have-shown that the neonate is
equipped, at birth, to actively engage in interaction
with the environment. For example, data strongly suggest .
that a baby's hearing is functional by 32 weeks gestation
(Eisenberg, 1970), that newboins are capable of conjugate
eye movements (Dayton, Jones, Steele, and Rose, 1964),
visual tracking across horizontal and vertical planes
,(Drazelton, Scholl, and Robey, 1966), and visual fixation
at an eight inch distance (Haynes, White, and Held, 1965).
6
7
The perceptual competencies of the young infant, such as
depth perception and size/distance relationships, are
likewise identified in the literature (Bower, 1966; Bower,
1965; Campos, Langer, and Krowitz, 1970), along with
,evidence that infants even have gustatorial preferences
(Nisbett and Gurwitz, 1970; Desor, Maller, and Turner,
1975; Engen, Lipsitt, and Peck, 1974). We now suspect
that the behavioral repertoire of a normal newborn infant
allows for the accommodation of characteristic care-
giving exchanges between the baby and her/his parents
(Goldberg, 1977; Schaffer, 1971).
Learning then, does not occur in a passive
sense, in the absence of at least rudimentary responses,
nor does it emerge entirely as a product of pre-programmed
genetic processes as a baby grows older. Deprivation
studies involving animals (Harlow, 1958; Harlow and
Harlow, 1965; Harlow and Zimmermann, 1959; and Maier,
1949), and young institutionalized children (Froirence
and Lipton, 1962) highlight the role of the environment
in the development of normal intellectual or pre-
requisite functions. Further, experimenters have
discovered that by manipulating environmental events
according to a specific strategy, responses can
predictably be elicited, shaped, lengthened, 4eneral-
ized or completely eliminated (Reese and Lipsitt, 1970;
Snell and Smith, 1978; Haring, 1977; Kauffman and Snell,
1977; White and Haring, 1976; Axelrod, 1977; Kazdin, 1975).
16.ti
8
Various manifestations of classical and operant con-
ditioning are now, considered responsible, by many
learning theorists, for much of our behavior. Consequently,
the operant paradigm appears in several published curricula
designed. for school-aged severely handicapped 'children
(Guess, Sailor, and Baer, 1976; Fredei.icks, 1976).
Classical (Fitzgerald and Brackbill, 1976) and
operant training techniques have likewise proved to be
effective at the level of infancy. The operant method,
in particular, when used either alone or in combination
with classical conditioning, was found to be successful
in changing behavior (reviewed in Sherrod, Vietze, and
Friedman, 1978; Ramey and Ourth, 1971; Sameroff and
Cavanagh, 1979). This research has shown that manipula-.
tion of variables, most frequently, consequences to infant
responses, can alter behavi'or such as head turns, kicks,
coos, and sucks (see Hulsebus, 1973 for reviewS;
Siqueland and Lipsitt, 1906; Rovee and Rovee, 1969;
Watson, 1972; Caron, Caron, and Caldwell, 1971; Fagen and
'Rovee, 1976; and Solkoff and Cotton, 1975). Young infants
even have beenAaught complex discrimination tasks using
conditioning procedures (Sheppard, 1969). Curricula
created specifically for intervntion with infant Popula-\:;
tions lend considerable credence to these findings
(Hanson, 1977; Dennison and Bricker, 1976).
Perhaps the key feature of operant programming
with infants lies in the requirement of active responding
by the baby. While the popular use of "sensory stimulation"
may have a purpose in eliciting some positive.effects,
(i.e., range of motion to prevent contractures,
proprioceptive feedback to encOurage normal posturing
and sensory experiences in cases of deprivation), it
generally implies passivity An the part of the recipient,
and its exact contributions to child development remain
unclear.
Data gathered from the Fels Infant study.
(see Lewis and Goldberg, 1969), indicated that over
stimulation of an infant's sensory receptors by random
stimuli actually prodUced a decrement in attending
behavior. Under such conditions, the more the infant was
passively stimulated, the less s/he attended. Studies
additionally have,disclosed that there is a response
decrement to repeated stimuli, t'habituation", that may,
in fact, be cortical. It is hypothesized that the brain,
after processing,the intensity, duration and quality of
a signal; retains it, and then produces negative feedback
resulting in a decreased or absent response (Hebb, 1949;
Sokolov, 1963; Lewis, 1967; Lewis, Goldberg, and Rausch,
1967). Without experience, the infant is unable to
control, process or act upon extrinsic stimuli. If these
conditions persist, s/he becomes at risk for a phenomenon
termed "Learned lelplessness" by Martin Seligm-An (1975).
Learned helplessness is characterized boy the cessation
of activity and initiative, and is brought on by
frustrated attempts to engage or control environmental
41 8
9
10
events. The condition has been observed in animals And
is believed to induce Paychological change within the
organism. It seems to be somewhat related to resignation,
an attitude Maier (i049) describes as having a "lack of
overt behavior", in which "motivation seems to be largely
absent".
Experience, then, must be gained according to
some highly organized plan, in which the organism. is
allowed to actively participate in deciphering, pro-6
cessing and eventually controlling extrinsic environmental
activ:ity. Jean Piiget has hypothesi'zed such a system, ,
which he ,described in the sensorimotor period of develop-
%ient (Piaget, 1959). With the help of intact sensory
receptors (which are largely in a reflexive state), the
neonate randomly moves for, what appears to be the enjoyment
of movement itself (with the exception of survival
responses). Experimentation with available behavior leads
to a rudimentary ability to discriminate the effects pro-
duced by certain actions. In stage three*(secondary
circular reactions) oflPiaget's developmental sequence,
the infant'seeks to continue a pattern which sustains a
pleasurable event. Stfhe finally learns to apply behavior
across situati,,,a, modifying them when appropriate. Piaget
attached special significance to the third stage of the
sensorimotor period because he felt it marked the onset
of intelligence. This stage includes intentignality, a
shift in interest from the response itself to the
1 81)
11
consequence of the response, memory and the'beginnings of
"contingency awareness" (Watson, 1966). Contingency
awareness refers to "an organism's readiness to react
adaptively in a contingency situation and to an organism's
sensitivity in the perception of contingency situations
when they occur," (Watson, 1966). Watson further suggests
that contingency awareness creates motivation to rect
further environmental change. Evidence of the motivation
was found in infants' responses to contingent experience.
Infants responded at higher rates when placed in a
contingent condition, (i.e., infant response produced
oUtcome), than in noncontingent, (i.e., outcome occurred
independent of infant response), and baseline conditions.
The contingent situation produced other positive effects'
such as increased attending, smiling and cooing. In this
experiment, using normal infants as subjects, head turns
produced the turning Of a mobile. Other studies in this
area have shown that infants have responded with
nutritive sucking contingent upon a head turn (Siqueland
and Lipsitt, 1966), non-nutritive sucking for visual
stimulation (Stern and Jeffrey, 1965), kicking to activate
a mobile (Solkoff and Cotton, 1975), vocalizations to
provide adult vocalization (Ramey afid Ourth, 1971), foot
thrusts to create conjugate visual stimulation (Rovee
and Rovee, 1969), social reinforcement contingent on a
touching response (Millar, 1976), and.contingent affective
responses between mother and infant (Lewis and Goldberg,
12m
1969). The contribution of these experiences toward the
motivation for further exploration and learning remain
speculative. The consistent findings of increased
positive and active target behavibr do, however,'indicate
that infants are motivated to interact" with the environ-
ment under contingent circumstances.
The motivation to learn was formalfy thought
to result from psychological drives. In 195q, White
hypothesized that motivation waS rather born out of
feelings of "efficacy", as the child con_jpeter_yitl engaged
in active exploration and manipulation of the environment.
Jennings, Harmon, Morgan, Gaiter, and yarrow referred to
14,
it as "mastery motivation" in 1979. Wenar (1964), called
it "executive competence", combining the theories of
White and Ausubel to deScribe these eesponses in one year
olds. Watson (1972), and Watson and Ramey (1972) found
correlations between theoinfants' activities and their*
affective behavior. Goldberg argues that early social
relationships are ehhanced by mutual feelings of efficacy
derived from reciprocal contingent interactions betwi-en
infants and caregivers (Goldberg, 1977). Watson reasons
that the nature of an infant's interactions are far less'
significant than the manner in which they take place.
In other words, regardless of its content, if a
situation provides a contimgent relationship, it has,
value. Watson hypothesizes that an infant's first aware-
ness of a clear contingency normally emerges from the
game-like interactions s/he engages in with her/his
parents. Concerning the value of the responses involved
he states simply, "The Gameis NOT important to the infant,
because people play it, but rather people ioecome.important,
to the infant because they play 'The dame" (WatsOn4 1972
And Watson 1979).
The interactions experienced-by. handicapped
infants may le both qualitatively an..7 quantitatively
different from thoSe experienced by normal babies.
Sensory deprivation during formative.periods of develoi
ment can result in failure Of tile deprived sensery
system to develop and function normalay. Neurophysio-
logical structuees 1.in these instances, have shown
abnormal growth from the distal sensory receptors,
through tfie sensory relay nuclei, to the cerebral cortex.
(Prescott, 1976). Information may be confusing, sporAdic
or simply inadequate for processing. Reflexes may be
absent, or abnormal, jeopardizing even survival. Move-
ment may be limited, involuntary or insufficient to
produce any effect, and thus the environment may offer no
constructive feedback. The typical route to development
is interrupted, normal channels of interaction blocked,,
and the infant derives frustration from futile efforts
at making sense of her/his surroundings. Severe and/or
multiple handicapping conditions may deny a child the
means to engage the interactional system. Additionally,
through continual unsuccessful, unreinforced attempts to
191
establiSh new behavior, the multaply handicapped 'infant
may accept incompetence and learn helplessness.
There are, however, indications that the
negative effects of sensory deprivation Can at least be
lessened. In 1957, Norris, Spaulding, and Brodie con-
cluded that blind infants showed selective developmental
lags (Cattell Infant Intelligence Scale) in those areas
'in which they'lacked experience. They also noted that
those infants who had bees allowed ahd encouraged to
explore their environment showed less of a deficiency;
(reported in Warren, 1977).
Though existing curricula for older severely
handicappedchildren may serve as a viable.resource
(Guess, 'Sailoi, Baer, 1976; Fredericks, 1976), they
would have to be considerably adapted to laccornmodate
behaVior specific to infancy. For instance, an inter-
trial interval, a peripd to.provide for clear onset and
offset, data recording and reinforcement, could be no
longer than a few seconds in duration (Millar, 1972;
Ramey and Ourth, 1971: Sherrod, Vietze, and Friedman,
1978; Watson, 1967); stimuluspresentations and conse-
quences must remain moderately novel to maintain the
infant's interest and prevent habituation (Kagan, 1'970;
McCall, 1973), and states of arousal must be monitored
to insure the infant is performing when most alert
(Brazelton, 1973;Wolff,.1976). . Curricula also are
available for developmentally delayed infants and
15
toddlers (Fredericks, 1976; Brf.cker,.1976; Hanson, 1977).
These programs are typically equipped with sets of tasks
representing differ,ent stages of developmeA-, and,include
behavioral training procedures. Theke curricula, however,
are primarily product rather than proceas oriented, arid
are therefore more concerned with skill acquisition than,
facilitating cognitive thought patterns. By including
a hpecific inst*uctionalstrategy for the attainment of
a specific skill,.there is a chance that the response
will be trained Ania-single, isolated context. Without
additional diverse experiences Utilizing the thought'
process involved, generalization of the skill may be .
precluded.
Clearly, alternative intervention methods for
severely handicapped infants mustioe explored. Tech-
niques should be designed to incorporate both behavior
specific to infancy, and the precision necessary to
pinpoint and accommodate minute iesponses.
Prosthetics and adaptive'equipment are common.
to special education settings. Traditional uses have
been to "prevent or alleviate deformities in the child
and neurological and 'or orthopedic problems", and/or
to "enable the child to function more normally in
therapy, in the classroom, or at home", (Campbelll Green,
And Carlson, 1977). During the past few years, several
experimenters have also discovered that such equipment
could be employed as teaching aids. Mechanical and*
electronic devices.complimented the operant teaching
paradigm by offering increased precision in both.the
detection and measurement of responses. Reinforcement
also could be dispensed systematicaly, eliminating
teacher error. The eduAtional merit was realized and
now the use of adaptive devices 'to elicit learning
responses is rapidly becoming a recognized feasibility.
Typically, a salient reinforcer is made available for a
given response; which ie measured by the,apparatus. The
experiments, primarily*'With older, severely and physically
handicapped individualb have'yielded promising results.
Most,utilized sensitive adaptive equipment to measure and
contingently reinforce slight changeS in behavior, i.e.,
increased range of motion (Ball, Combs, Rugh, and Neptune,
1977), controlled arm movements (Murphy and &nighty; 1977),
drawer pulling and doorknob rotation.(Friedlander, Kamin,
and Hesse, 1974), and head posture (Ball, McCrady, and
Hart, 1975); More recently,_Zuromski and colleagues,.
(Zuromski, Smith, and Brown, 1977; Acctino and Zurotski,
1978) have demonstrated that electromechanical devices
can be used to teach sitple discrimination tasks and motor
responses (i.e., arm movements) to multi-liandicapped
t.institutionalized children.
Commonly in these studies, %here is a lisparity
between the targeted-response and the consequencc,. A
possible explanation for this condition may be
difficulty one encounters finding salient reinf rcere for
.16
0
17
severely handicapped persons. Strong.reinforcement is
necessitated by a lack of motivation to,perform skills
that otherwise hold little meaning for the subject. The
targdted response may be acquired, but the situation
remains 1;Ighly contriVed, and may require additional
training f* generalization. The'functionality of the
skill, by definition, becomes questionable. Guess,
Horner, Utley, Holvoet, Maxon, Tucker, and Warren, 1978, .
'set the following-criteria for fUnctionality. A functional
rdsponse is one that 'U.), _Produces an immediate con-
sequenCe for the childf 2) Is reinforcing; and 3) Combined
with the consequence, Is natural to*the child's inter-
-action with the:socio-ecologicil or prosthetic environment".'
Teaching an isolated skill, unrelated to its consequence,
does not qualify as natural to a child's interaction with
the environment.
The major role of learning devices in most.of
these experiments appears to be to increase or teach a
-given response. Learning devices can also be used to
teach cause and effect.rerationships. The subject learns
that _the response is important because it produces an
effect, or change in conditions that s/he can control.
The consequationv approach and degree of response may be
manipulated per device. If the terminalobjective is
cause and effect understanding, then variety must be
employed to increase the probability that the skill will
generalize. Perhaps contrived situations could be
19,0
4
18
avoided by 'providing opportunities with contingency
devices:early in the pos't natal,period. Ideally,
naturally occurring phenomena would then become
sufficiently reinforcing,'eliminating the need for .
exaggerated and conspicuous training techniques with
severely handicapped persons.
The advantage a_learning aevices ari many. They
include: detection of minute changes in r onding,
Systematic and immediate consequationt easy set-up and4
transport, and simple cbnstruction. Most importantly,
they can usually be hdapted or modified to suit individual
needs and diverse programs, which makes them Post
efficient and lessens the possibility that they will be
misused.
Learning devices are by no means a parent o;
teacher substitute. -In .fact consequation may well involve
contingent interactions with an adult (Ramey and Ourth,
1971; and Watson, 1966). Learning davices primarily serve
as accurate indicators of behavior that may otherwise not
be identified by the environment.
laarilaa
Theoretical perspectives and evidence gathered
in research investigations document that infants require
active involvement with the environtent for optimal
development. Normally, an infant is born with sensory
receptors and a behavioral repertoire ready to
accommodate exchanges with her/his surrouridings. With
1 96
1
,repeated exposure 'and experimentation, the infants learns
to anticipate and control cause and effect associationa.
The motivation to initiate further understanA.ing,Of
environmental phenomena may result from the feelinda.of
efficacy the infant derives from,suCcessful interaCtions.'
Mhen an,infant is unable to control the environment,
s/he may become.frustrated and acceptItncempetence.
Severely senaory and/or physically impaired 'children are
at risk for learning helplessness becaupe they canhot
achieve interaction through normal channels. The
environment often does 'not recognize their attempits be-
cause they may be difficult to detect, and,therefore, it
does not offer feedback. Training techniques to prevent
the lack A feedback have been incorporated into.curricula
designed for severely handicapped childrenio Such pro-
cedures have also been incorporated into curricula for
developmentally delayed infants and toddlers. The
problems apparent in many of these programs are; 1) they
do not address issues of infant behavior; 2) they train
isolted skills instead of concepts;',and 3) they depend
on human observation only for the assessment of responses.
Learning devices, though primarily used for
other purposes in the past, may prove useful tools in the .
detection, measurement and'consequation of minute
responses'erhitted by handcapped babies. Perhaps they can
also aids.in teaching Cause and effect relationships,
a)functional response that Aay eliminate the need for
1
19
exaggerated or contrived training techniques later'onijn
1
life. A mdre obvious use is to.increase oi teach
iSolated motor skills. 'The advantages.of employing such
equipnent are many. They:may\be used in combination with
training from. he parent(s):or teacher, they are cost
efficient, adjustibld and easy to transport.
This study'investigates the effects of'daining,
two motor responses on learning equipmet. This procedure
is then compared to.,a more common, 'Illand...-on" approach',
,involving consultation: wi.th an occupational therapist.
A
CHAPTER IZI
Methods and Procedures
Subjects
The infants involved in this investigation
were choden from those enr011ed in the Richmond Early
Childhood Education Project'(RECEP), a fe-derally.funaed
demonstrationjmoject affiliated with Virginia Common-''t
wealth University and the RichoOnd Public SOoól.system.,
This program presently serves infants and pteschoo ers
from birth to six years*of age who are determined to beI .
at leastfifty percent 7 more delayed in their develop-
ment. This means that with prematurity taken into
consideration (corrected age); their developmental skill
levels resamblq thode.of either a child half their'ade or
younger. RECEP encourages parent participation and bothIN
parents and staff ere trained in various interventions
with all children. Out of the 18 infants (birth to two
years) atending, only two resembled each qther motori-
cally and needed training qn similar skills. Both'
subjects were black males aged between 12 and 24 monthsV
hactsevere motoric delays and significant developmcintal
delaysiqn most othet skill areas. The parents of both'
sulijects also eXpresz;ed a wilaingness to have their infants
participate in the study.
21
22
Subject one was described as being.hypotonic,
with low muscle tone and a floppy appearance. He had
*head control, righting responses and some sitting balance.
The public sctlool visual itinerant reporteq tha.t this
infant had acuity, and slow /but present tracking responses.
He was 22 months old when the investigation began.ft
Subject two was described as having ataxic
movement,*charcterized by fluctuating muscle tone. He
also had head control, righting responses and sOme.sitting
a balance. Visual responses were likewise intact for this
subject. He was 1(4 months of age at the beginning of the
.study.
An assessment conducted by the oàcupational
therapist (Developmental Screening. Inventory; Gesell
and Amatruda, revised, 1980), and the investigator
(UniforM Performance Assessnient Scale; White, Edgar
and Haring-, 1978), prior to the investigation showed that
both subjeCts had unilateral reaching responses. Voli-
tional grasps w6re absent in the repertoire of subject
one and minimal for subject two. Reflexive behavior had
evidently been integrated in both infants. Both were able
to bear weight momentarily in a prone position* on their
forearms. Weight bearing,on extended arm-Fibuld not be
elicited in either infant.
Prior to experimental treatment, the parents
of each subject were given written explanations of the
study. The investigator then met with each in order to
)
answer questions and address concerns. . At this time the
tentative training sthedules were dfscussed and consent
forms, (included in the appendices)'irere signed.
getting
The infants received training for bqh treai-.
ments in the infant,\classroom. This room is located in4/
a self-contained public school for the severely handi-
tapped. Preparatory procedures for tkeatment 1 were
administered in the center of the classroom on a carpeted
floor (night bearing) and in the same location in a
carrier for the bilateral reach/grasp response. Sessions,
were viddo-taped with a Sony portable tape player, a
camera and a monitor. The taping-on the equipment took
place in the southeast corner of the classroom, facing
a wall consisting predominately of windows. Videbtape
equipment remained visible over hll phases. A black
curtain,situated on either side of the devices was used
evf
to minimize visual 4istraction. (See Tendix 2 for dia-
gram of classroom.) Exact conditions existed throughout
the study with the exception of sporadic peribds of
background noise.---j
dr. \i.-C I?
The equipment was constructed to fit the
infants' needs with input from the occupational therapist.
e /
4.., ...
4
One utilized microswitches that could be triggered by a
certe.n amount of pressure. It was designed to detect
and consequate equal weight bearing. ?e.Other device,
had a wire and' conductive.tape switch,. its purpose was
20[.1
23
24
to train a bilateral reach/grasp. .The,reinforcement
contingent on these responses was chosen froth those
/stimuli reported in research studies to be preferred by
normal infants (i.e., reflective colored paper and
lights). Habituation and satiating effects were
imized by staggering A.M. and P.M training sessions and (
'-'
rotating visual displays (three per device)-every ttme a-
subject used a particular piece of equipment.
Additionally, the two sets of displays differed with
respect to each other. yDifferpnt combinatidns of colored
Christmas-lights were used forthe weight'bearing device
while illuminated foil and colored acetate was used for
the bilateral reach/grasp equipment. Design specificatins,of the learning eqUipment are included inppbndix 8.
Responses were counted during ten minute sessions
beginning approxiMately 10 seconds after the infant was
positioned for each of the treatment phases.
Experimental Design
A single case, multiple baseline design within
subjects and across tasks was.used for this study. The°
design is typidally used to show the effects of treatment
.andlgeneralization by intervening on a single variable
a time, while carrying out another or others under
baseline conditions. In this way, functional relation-
'ships between treatment procedures and changes in
behavior can be identified (Hanson and Be14.amy, 1977;,
4414
Hersen and Barlow, 19 This study differs pnly in'
that it includes a. treatment (1) that c.an also be.
2perceived as an additional baseline or intermediary phase
to which the experimental'condition was compared.- The
.motor responses chosen, in keeping with the design, were
both topographically and functionally dissimilar.
,Baseline data was collected over a four day
peribd prior to treatment to insure that the responses
41.
were not already in the subjects, repeitoire. Training'
using (treatment i procedures (standard) was initiated
25
Cr'
for both skills following baseline for each subject,,,andIC-
carried out for 10 sessions. Treatment 2 (learning
equipment) was then implemented, and training with this AJ.
A' e .
procedure occurred for another 10 sessions involving
only one.response per subject. A three session continu-
ation of prior conditions was afdded one week after the
experimental phase had terminated. The study ran for a
duration of fourteen'weeks.
Independent Variable
Treatment orocedurei, standard (1), and those
involvin4 the learnikg equipment (2)', constituted the
3 independent variable.
a. Treatment 1 consisted of two motor trainidg
procedures conceived-ofcooperatively by the
classroom teacher and occupational therapist
on staff. The program followed an operant
or measurable paradigm and employed tecnniques
borrowed from Bobath and Rood. Subjectso
received proprioceptive input, were prbmpted,
and reinforced with tacti.leand miditory
praise. The light displays were continuous.'"
JSee. ppendiX 6.)
203
26 f
b. Treatment 2 utilized learning equipmentto train the two motor responses. Thereinforcement available (light displays) (.A''
was response contingent. Subjects wereprompted only. (See pendix 7.)
Dependent Variables
The dependent variables were:
1) motor skill acquisition, as meaSured by rate of res-
ponding
bilateral readh/grasp: bilateral reach andsimultaneous grasp of lateral portions of steering
wheel on apparatus independent of prompting
weight bearing: eq4al-distribution of weight anextended arms in lateral midpoint sectors of, switch
platform with palms down, independent of prompting
2) approximation of motor skill, as measured by rate of
responding
bilateral reach/ ras : maintenance of a prompt,
contact of han s or close proximity of hands (within
a two inch distance to lateral portions of steering
wheel)
wei ht bearin : bilateral hand placement in lateral
m dpoint sectors of switch platform as the result of
prompt maintenance and/or equal 6ut insufficient--4weight bearing on extended arms with palms facing
down and in lateral midpoi:nt sectors of switch
platform
3) attention, as measured by duration of visual fixation
visual fixation: the fixation 00 f the subjects' -eyes
on the display panel provided 'by the device
4) chapge in affect, as measured by frequency of smiling,
voealizations and fussing and duration of crying
smiling: upturning of,corners of mouth
vocalization: voiced, playful and/or unagitated
utterance occurring on a single exhalation
fuss: whine, agitated vocalization_frequentlyaccompanied by a grimace or frown and/or an attempt
to change position, on one exhalation
21)
cry: 'long, even vocalizations typically accompaniedBY-squinted or closed eyes, tears, and a gasp at the
end of the exhalation
5) Changes in state were documented both before the childwas placed on an apparatus and immediately following
the session. (Reference for deterthining state ofarousal was Brazelton, 1973.) See tppendix 3 for
definitions.
Experimental Pnases
Pilot. Both leaining devices were pils.)ted
before the investigation to,make sure they weret
mechanitally sound. The two additional subjects chosen
to test the devices were both black males, one six months
of age and the other, Over twoyears: 'one was severely
handicapped, the other, within normal limits cognitively.
Both were mildly motOrically i aired. Parental consent
was obtained to run these Sessi ns, which were also video-
taped. Both subjectS were.successful in activating both
pieces'of learning equipment.
Baseline. Baseline data was collected on each
experimental subject in order to determine whether or not
responses were present in their.repertoiie. The subjects
were positioned on the learning equipment for four 100
minute sessions per device. Three second physktal
prompts were given initially and after a one minute
duration. Light displays were continuous and no conse-
Aquation was available for responses. (See ,ppendix 5.)
Treatment'l. Treatment 1 described a standard
motor training strategy involVing a collaborative effort
between the staff occupational therapist and the class-
room teacher, who devised the program plan. Training
included preliminary proprioceptive procedures, followed
by positioning on the learning equipment. The programs,
which incorporated Bobath and Rood techniques, consisted
of behavioral or measurable descriptions of positioning,
stimulus presentation, and consequation (tactile and
auditory) for appropriate responses. (See appendix 6
for indepth description.)
Treatment 2. Treatment 2 involved the adaptive
learning equipment and required therapeutic input only to
identify the tasks to be taught and.to determine the
bhild's position prior to interaction with the equipment.
-
Reinforcement in the form of colored light displays for
28
a targeted motor response was provided by closing electronic
circuits. Reinfor.cement was available only at the time
the targeted behavior was being performed. That is,
'the consequation and response bccurred simultaneously.
(See appendix 7.)) I
The treatment with the learning equipment took ' 1
place in two ten minute sessions per day, once in the
early mornipg and once at noon, three to four days per
week (usually Tuesday through Friday). Prior to the
experiment, the investigator determined that these
particular subjects would be alert auring these times.
The sessions remained uniform throughout the study.
Carryover of treatment 1,procedures into
1
. routine caregivingactivities occurred to a certain
>,
extent during the time when treatment 2 was im effect.
For example, training in self-feeding necessarily
.
inVolved additional work on reaching and grasping.
Training on the equipment, however, was restricted to
the designated teaching times..
Additional Sessions. A continuation of prior
phases was taped one week after the termination Of the
sessions containing the experimental treatments.* These
few sessions provided additional information as to the
maintenance of skills acquired under the same conditions.
E.2,2_aer.P,r1,2IreSerir
A prompting procedure was Used over all condi-
tions, occurring once, at the beginning of.each session,......_
and aaain one minute after the session had begun. For,
weight bearing, the prompt,consisted of downward predsure
t
,
on the subjects' shoulders while elbows were extended and
palms were resting downward on the switch platform. Each
prompt lasted for a three second duration. Prompting for
bilateral reach/grasps consisted of a full hand prompt
(experimentets hands encompass subject) to each hand
around the steering wheel, also.for a three second
duration. All prompts were administered with the
experimenter positioned behind the subject andremained)
uniform throughout the study. No responses occurring,
during prompting were recorded.
Subjects were made comfortable and state was
controlled as much as possible before training. Diapers
r
20 ,
. 29
/
were.checked, and if necessary, changed, noses, were wiped
or suctioned, and subject's were dressed ,appropriately.
Subjects were not trained if they were ill
sleeping or crying. states. If crying occurred during
training, thb experimenter attempted to comfort the
infant on the equipment while continuing the spssion. If
sleeping occurred, the'session was terminated.
Data Collection and Analyses
Weight bearing responses and approximations,,
bilaterhl reach/grasP approximations, visual fixation and
crying wete measured by the number of seconds they occurred.o
Bilateral"reach/grasp motor responses, Smiling, vocaliza-
tions and fussing were measured'by frequency of occurrence.
Data on the frequency or duration of the responses were
collected by the experimenter after reviewing the video-
tapes.. Research assistants were then emPloyed to separately
read and record all of the same responses after they were
screened and scored on the components of each behavior they
were observing. The results of this study were analyzed by
. a visual comparison of slopes of the acquistion of
behavior occurring under the two training conditions.
11.-Lit=2.LDserveriabilit
Interobserver reliability checks were performed
on all behavior for all sessions. Percent of agreement
was calculated by dividing the number of obsekver
agreements by the number of agreements p1us.4-disagree-:
ments and then multiplying the quotient by 100.
200
,
30
A
'
CHAPTER IV
Results
4
Motor Re222.0211;JnauL21222:2202aLiena
Subject I exhibited few responses under both
standard and experimental training conditions on the
bilateral reach/grasp equipment. Standard training pro-
cedures, used throughout to elicit the weight bearing
behavior (Subjedt'l), were likewise unsuccessful. Thei:e
were, however, increaseS in approximations of these
responses. Bilateral reach/grasp gpproximations'first
occurred in the last session of baseline. During treat-
ment I, they increased, peaked, and then subsided. Under
treatment 2, they became variable, but weke still hivh
and climbing at the end of the phase. One week later,
in post-training sessions, the rate of responding had
been maintained. Approximated weight bearing responses
for the same subject were ariable, and decreased from
the first to Second treatment (11 phase. Responding
during post-training.sessions accelerated, possibly
indicating a repetition of the variable pattern seen in
earler training. (See figures 1 and 2.)
. 31
20 i
)
21
SUBJECT 1.
BILATERAL REACH-GRASP : 100% RELIABILITY
100
90
80
ZO
60
so
40
30
20
10
0DAY.
SESSION
100
,N
80
70
60
5,P
46
30
20
10
0:DAY
ts) SESSION
:BASELINE T1
,....
T2
r
,.
POSTSESSION
..
T T H T T H
2 4 6 8
T W TH T W TH T
2 4 5 7 9 12 14
WEIGHT BEARING : 100% RELIABILITY
BASELINE
1
04
T1
NI W T H15 1/ 20
t
W TH F T W TH F T W
2 it 5 7 9 12 14 15 17 20
,
T1e.
r
T W TH1 2 3
e
ivsr-scssioN
i' sw,
T TH T TH T W TH T W TH T IA W TH T WTHF T.WTHF T W T W M3 5 7 ' 1 3 8 8 10 11 13 16 18 19 1 3 6 8 10 11 13 18 18 19 1 2 3
r ..
21.1.
SUBJECT 1
BILATERAL REACH -GRASP : 901% RELIABILITY
275 BASELINE
250
225
200
175
150
125
100
75
so
25
0DAY
SESSION
T1T 2 POST- SESSION
IC
275
250
225
200
175
150
125
100
75
50
25
T TH T TH2 4 6 8
T WTHT WTHT MWTH T W TH F T W TH F T W
2 4 5 7 9 12 14 15 17. 20 2 4 5 7 9 12 44 15 17 20
WEIGHT BEARING :91% RELIABILITY
BASEL INE T1
T TH T TH1 3 5 7
T 1
T W TH1 2 3
POST-SESSION
IC
T WTHT WTH T MWTH T W THF T W THF T W T W TH
1 3 6 8 10 11 13 16 18 19 1 3 6 8 10 11 13 16 18 19 1 2 3
XI 4
3 U)rn 0
.ZC cn
m
3m >Z
73
*0Cn Xrn-0o .?!.4
213
34
Weight bearing motor responses appeared under
treatment 2 conditions for subject 2. The bilateral
/ reach/grasp behaviortrained under standard treatment (1)
procedures showed little change from ptase to phase.
ApproximatiOns of the weight bearing Motor response
similarly accelerated under treatment 2 conditiCms, while
approximations of reach/grasp behavior were generally
variable; with lowered responses at the terminatiOn of
treatment 1 and poi3t-training sessions. (See figures 3
and 4.)
Visual Fixation Smilin and Vocalizations
Visual, smiling and vocal responses for both
subjects were variable and did not change significantly
as a result of treatment. (See figures 5, 6, 7, 8,.9 and
10.)
Fussing and Crying
.Fussing and crying occurred infrequently during
training with the bilateral reach/grasp equipment. The
incidence of these responses did not seem specific to
any treatment phase for either subject. (See figures 11,
121,13/and 14.)
Fussing on the weight bearing equipment ,was
'high and variabae for subj., and increased in the
second phase of the standard treatment strategy. These
increases occurred simultaneoUsly with decreases in the
infant's crying responses. (See figures 11 and 12.)
Fussing and crying behavior were similarly variable for
ot
SUBJECT- 2
WEIGHT 'BEARING ":85.7% REMABILITY
BASEb.INE T1
100
so
, 80
80
50
40
ao
20
10
0DAY W F M M T W T H T W T H F W T H TSESSION 2 4Q 6 8 2 4 5 7 9 12 14. 15 18 20
BILATERAL REACH-GRASP :100% "RELIABILITY
4e.
12
4
BASELINE T1
100
90 fr
80
70
60
50
40
30
20
10
0DAYSESSION
2,I6
F TH3 5 7
T WTHT WTHFWTHF3 6 8 10 11 13 18 17 20
W TH F T W TH T W F
2 4 5 7 9 12 14 15 18 20
T1
POST-SVSSION
X
1 2 3
03F m> 5x
."1> Dor
POST-SESSION m 313.z0 0o frin
w-0 z1 CI
13
0
1' W TH F T W TH T W F T VI F1 2 31 6 8 10 11 13 16 17 20
216
SUBJECT 2
275
250
225
200
175
150
125
100
75
so
WEIGHT BEARING :92% RELIABILITY
BASELINE
1.
T1
25
0...m...Z..,.................~DAY WF MM T WTHT WTHF WTHT TWTHF T WTHTWF T W F
SESSION 2 4 6 8 2 4 5 7 9 12- 14 15 18 20 2 4 5 7 9 12 14 15 18 20 1 2 3
T 2 POST- SESSION
)
.
xc.
0.
275
250
225
200
175
150
125
100
75
50
25
BILATERAL REACH-GRASP :93.7% RELIABILITY
BASELINE
0 . 4.......
T1 T1 ii
POST-SE:SION
2 1 II DAY W F TH F
SESSION 1 3 5 7
T WTHT WTHF WTHF T W TH F T W TH T W F
1 3 8 8 10 /1 13 18 17 20 1 3 6 8 10 11 13 16 17 20 _ 1 2 3T W F
S
*
4.,
21.6
woN
\
SUBJECT 1
BILATERAL REACH-GRASP :92% RELIABILITY
550
500
450
400
350
300
250
200
150
100
50
BASELINE Ti
0DAY TTHTTH YWTHT WTHT MWTHSESSION 2 4 6 8 2 4 5 7 9 12 14 15 17 20
WEIGHT BEARING :89.8% RELIABILITY
550, BASELINE
500
450
400
350
300
250
200
150
100
50
0DAYSESSION
2
T1
T2 POST-SESSION
T WTHF T WTHF TAY T W TH2 4 5 7 9 12 14 15 17 20 1 2 3
1:3
T TH T TH1 3 5 7
TWTHT WTHTMWTH1 3 6 8 10 11 13 16 18 19
TWTHF TWTHF TW1 3 8 8 10 11 13 16 18 19
T W TH1 2 3
crn
Z <
0
0
fl
22
./
,
SUBJECT 2
WEIGHT BEARING :92.2% RELIABILITY..
550 BASELINE T1 T2 POST-SESSION
4
5001
45,0
400
350
300
25() '
200
150
100
50 x
0DAY
A---a---A---&----:".&----" .......41........./.\\.. ,,,...,.W'F'PAPA' T
46.W THT WTHF WTHT T W TH F T W TH T W F T W
SESSION 2 4 6 8, 2 4 5 7 9 12 14 15 18 20 2 4 5 7 9 12 14 15 18 20 1 2 3
BILATERAL REACH-GRASP :94% RELIABILITY,i550
45:301
400
.350
300
250
200
150
100
BASELINE.
*
\A
T1 POST-SESSION
DAY W F TH FSESSION 1 3 5 7
T wTHT WTHF WTI1F1 3 6 8 10 11 13 18 17 20
x
T W TH F T W TH T W. F T W F
1 3 fo 8 10 11 13 18 17 20 1 2 3
CDIII00Z00
23m64)"ti0Zu) 'MS
<IMO '
CAC>rMX>"40Z
222
SUBJECT 1
BILATERAL
11
1019
8
7
6
5
4
3
2
1
BASELINE
REACH-GRAS! .:91% RELIABILITYT1 12 POSf-SESSION
DAY T TH T TH
SESSION 2 4 tlit 8
11
10
9
8
7
8
5
3
2
1
0
TWTHT WTHTM2 4 5 7 9 12, 14 15
WEIGHT BEARING :100% RELIABILITY
BASELINE T1
TH17 20
41161WTHF T WTHF T Y? T W TH4 5 7 9 12. 14 15 17 20 1 2 3
T1 POST-SESSION
DAYSESSION
T TH I TH1 3 5 7
, 223
T W TH T W TH I M W TH1 3 6 8 10 11 13 16 18 19
T W TH F T W TH F T W
rnCD
0 u
LIJ
T W TH ID
1 3 6 8 10 11 13. 16 18 19 1 2 3
224
SUBJECT
WEIGHT -BEARING : 100% RELIABILITY
11 9ASELINE 11
10
9
a
7
6
5
3
2
0DAY W F PA Pi T W TH I W TH F W TH T T W TH F T W TH T W F T W
12 rOST-SESSION
to
,
SESSION 2 4 6 $ 2 4 5 7 9 12 14 15 18 20
BILATERAL REACH-GRASP :93.6% RELIABILITY
11 BASELINE
10
9
2 4 5 7 9 12 14 15 18 20 1 2 3
DAY W F TH FSESSION 1 3 5 7
223
T WTH T WTH F W TH F
1 3 6 8 10 11 13 18 17 20.T W TH F T W TH T W F T W F1 3 6 8 10 11 13 16 17 20 1 2 3
.
33rn(I)-a0. zCiirn
CA
CFz0
226
SUBJECT 1
BILATERAL REACH-GRASP, :93.4% RELIABILITY
275 BASELINE
250
'225
200
175
150
125
100
75
. 50
25
0DAY
SESSION
T1T2 POST-SESS1ON
T TH T TH T,WTHT WTHT M2 4 6 8 2 4 5 7 9 12 14 15
WEIGHT BEARING : 89.7% RELIABILITY
275 BASELINE
250
225
200
175
150
125
100
75
so
25
0DAY
12Tif
T TH T TN1 3 5 7
17
TN20
T W TH F W TH F T W T W TH2 4 S 9 12 44 15 17 20 1 2 3
T W TN T W TH T M w TH3 6 8 10 11 13 18 18 19
T WTHF T WTHFTW1 3 6 8 10 11 13 16 18 19
T W TN1 2 3
228
SUBJECT 2 /WEIGHT BEARING : 89.2% RELIABILITY
275
250
225
200
175
150
126
7
50
25
0DAY WF MM TWTH'T riTHF WTHTSESSION 2 4 6 8 2 4 5 7 9 12 14 15 18 20
BILATERAL REACH -GRASP :91.8% RELIABILITY
BASELINE T1 T 2
-4
1
POST- SESSION
275
250
225
200
175
150
125
100
75
SO
25
t
8ASELiNE
1
T1
)
T W TH F 'T W TH T W2 4 5 7 9 12 14 15 18 20
-.
T1
W
1 2 3
POST. SESSION
DAY W F TH F T WTHT.WTHF WTH F T W TH F T W TH T W F T W FSESSION 1 3 5 7 1 3 6 8 10 11 13 16 17 20 1 3 6 8 10 11 13 16 17 20 1 2 3
.
SUBACT
BILATERAL REACH-GRASP : 91-8% RELIABILITY
275 BASELINE T1
250
225
200
175
150
125
100
75
50
25
DAY
SESSION
WEIGHT BEARING
T 2 POSE SESSION
275
250
225
200
175
150
125
100
75
25
T TH T TH T W TH T W TH T M W TH T W TH F T W TH F T W2 4 6 8 2 4 5 7 9 12 14 15 17 20 2 4 5 7 9 12 14 15 17 20
:90.5% RELIABILITY
BASELINE T1 T 1
T W TH1 2 3
PosrsEssioN
4
DAY T TH To TH T WTHT WTH'TM WTH T W TH F T W TH F T W T W THSESS ION 5 7 1 3 6 8 10 11 13 16 18 19 1 3 6 8 10 11 13 16 18 19 1 2 3
2:33t 2 3 '
cocn
SUBJECT I
BILATERAL REACH-GRASP :100% RELIABILITY
550 BASELINET2 POSTSESSION
500
450
400
350
300
250
2 00
150
100
10
0DAY
SESSION
T2
TH4
T
6
TH
8
T W
2 4
T H
5
T W7 9
T H
12
T
14
M
15
W
17
TH TWTH.F20 2 4 5 7
TWTHF9 12 14 15
TW17
T
20 1
W2
Tel
3
WEIGHT BEARING :92.8% RELIABILITY
550 BASELINE
500
450
400
350
300
250
200
150
100
50
0.DAYSESSION
T1 T1 POST-SESSION
TTH TTH T WTHT WTHIMWTHUiT WTHF T WTHF TW T wm1 3, 57 1 368 10 11 131618 19 1 3.68 10 11 13 16 18 19 1 23
234
k
SUBJECT 2
WEIGHT BEARING :84.6% RELIABILITY
275
250
225
200
175
150
125
100
75
50
BASELINE T1*
1
DAY WF MM TWTHT WTHF WTHTSESSION 2 4 8 3 2 4 S 7 9 12 14 15 18 20
BILATERAL REACH-GRASP :84.1% RELIABILITY
275
250
226
200
175
150
125
100
75
50
25
0
BASELINE T1
1
12
e
i
POST-SESSION
x
T W TN F2 4 5 7
T W TN T
9 12 14 15
T1 POST-SESSION
I1
x
DAY
SESSION
W F TH1 5 7 1 3 6 8 10 11 13 16 17 20
23 ,)
F T yiTHT WTHF WTHF T WTHF T WTNT'W F1 3 6 8 10 11 13 16 17 20
T W F1 2 3
II
)
el
SUBJECT 2
WEIGHT BEARING :89.1 RELIABILITY ,..
550
5061
450
400
350
300
250
200
150
100
501
01DAY
SESSION
BASELINE
,
T1 12
-
...
POST-SESSION
x
,..
W F M2 4 6
BILATERAL
550 BASELINE
500
450
400
350
300
250
200
150
100
50
0DAYSESSION
M T W TH8 t 4 5
T W TH7 9 12 14 15 18 20
REACH -GRASP :93.9% RELIABILITY
F W TN T
-XtI
w TH2 4 5
F T W TH T W7 9 12 14 15 18
T1
F
20
T W F1 2 3
POST-SESSION
W F TH1 3 5 7 1 3 6 8 10 11 13 16 17 20
23 'iF T W T H T W T H F W T H F
le
T W TH F I W TH T W F T W F1 3 6 8 10 11 13 16 17 20 1 2 3
236
subject 2, except that both of these responses dropped
out at the end of the experimental treatment (2) phase.
(See figures 13 and 14.)
State of Arousal
Changes in state during training with the
reach/gradp equipment were slight for subject 1, and did
not alter differentially, according to training. This
subject generally' trained inAlert Subj'ect 2,
who received only standard training with t e reach/grasp°
behavior, tended to become fussy or sleepy during
sessions on this equipment.
Changes in state during training with the
weight bearing behavior were more dynamic for both
subjects. Subject 1, who was trained using only(standard\\
procedurbs, turned from alert to crying and/or fussIng
states. Subject 2, who was trained using standard and
then experimental treatment procedures, became pro-..
47
,
gressively more drowsy toward the end of training
. C- 111.1-7tt.,
sessions (See tables 1 and 2.)4-YoA
The results of this.investigation do not suggest
that one teaching approach is far superior than the other.
Yet most motor and/or approximated motor responses
elicited under experimental treatment conditions were
maintained, providing some evidence to support the claim
that response-contingent training with learning equipment
may produce more lasting effects.
Though visual, smiling and vocal responses
did not vary with respect to treatment strategy, they
STATE OF AliOUSAL
Subject 1
Wei ht BearinBaseline
----------------,InItial
,
4444
Final
4444
i
Initial
4444
Final
66
66
Treatment 1
4 4 4 6
4 4 3 6
4 4 3 6
5- .5 4 6
4 4 , 4 6
,-- 5 4 4 5/6
4 5 4 6
4/5 4/5 1 1
3 5 4/5 6
5 5 4 6/3.
ent 2 Treatmen
48
4/54/5 1
45
44
65/6
4 I4/5 4 5/6
4/5 I 5 5 4/5
5 4/5 4 5/6
1 4/5 4 4 5/6
4 5 4/5 5
4 4 4 5/6 .
4 4 4 6
4 4 4 4/5
Post Training
4/55
44
555
1
66
3
2.
Subjeci 2
*
STATE OF AROUSAL
Wei ht Bearin
Baseline
Initial
4344
, Bilateral Reach/Grasp
Baseline
Final
33
3
5/6
Initial
4454
Final
442
/ 4
=1yes111...Treatment 1 Treatment 1
4444 -445
3/454
3
6
45
2
3
2
3/43
3
4 3
4 4
4 4
5 4
5 5
3 4
5 4
3 2
4 4
5' 2
Treatment 2 Treatment 1
4/54ss
4/55/65
ss5
3
3
63
3
3
3
4/55/62
54/55
45
4345
4/5
245443
44/534
Post Training Post Training
5
5
3
3
2.1 ,
6 5'
49
ler
may(have been more difficult to achieve on the weight
bearing equipment because of the positioning required to
perform the motor behavior. *Fussing and crying occurred almost exclusively
during weight bearing training. For subject 1, fussing
eventually began to replace crying. For subject 2, both
fussing and crying decreased together at the end of the
last treatment phase (2).
Changes inLstate may have also been influenced
by the type of apparatus in addition to 'the,training pro-
cedure. Subject I maintained alert statei under the
treatment 2 strategy on the reach/grasp equipment, while
continuing to fuss and Cry on the weight bearing equip-
ment under,standard training conditions. Subject 2,
who received only standara training on the bilateral
reach/grasp behavior, changed from alert to fussing or
sleeping states. This same subject, when weight bearing
under treatment 2 conditions, showed decreased rates of
fussing and crying by the end of the phase.
ReliabilitY
ReliabiLity was calculated across all conditions
for each subject and response, and ranged from 84.1% to
100%. (Exact figures included on graphs.). .
24 -,
,CH4PTER V
1.
Disdussion
Some increases in motor and/or approximated
behavior were exhibited by 'the experimental subjects '
under training in each treatment phase. The incTeases, ,
werei in most instaneVs, more substantial Under.the
contingency (treatment 2) strategies. This finding may e
either represent slight treatment effects, matAuft9I 7-110.1.
or the extra amount of practice the subjects received with
//
Y
the responses in prior training (treatment 1). Visual /
inspection of the data does, however, suggest another
difference in the effects of the two treatrnent strategies.
Generally, under treatment 1 conditions, the initial
increase in motor and/or approximation behavior was
followed by a steady decreade toward the end of the treat-
ment phase. Under the treatment 2 conditions, the
experimenter notpa an increase of approximation behavior
following prompting procedures, and, as the data confirms,
comparativeily high rates of approximated)oehavior
throughout subsequent training. (These responses were
typically maintained in post-training sessions.) Possibly,
k:44
the maintenance of responses.over treatment 2 training .
conditions was due to the subjects, continued interest in
51
243
e..
activating the stimulus. If this werein faCt true, the
infants May have been actively and intentionally seeking
to repeat the action-outcome pairing. The efeort may be
interpreted as'an attempt to exercise control over
environmental phenomena. Theoretically, then, the ihfants
were engaged in a learning process, albpit in,the absence
of adequate reinforcement (approximations) fin- their
persistence. Subject 2 eventualYSr. learned to engage the
light display by employing the targeted weight bearingsr,
motor response: The same subject apparently lost interest
under continued treatment 1 conditions with the bilateral
reach/grasp equipmeht. Subject 1 did not acquire the
targeted motor behaN>idt, but did exhibit increased and
sustained approximated responses during the treatment 2
phase.
DifficultieS in ascertaining the exact causes
of discrepancies in responding under different treatment
conditions were due to both intervAing variables and
flaws in methodology that -.0ere not foreseen. They include:
11) insufficient training time
Although the training sessions lasted for
a 10 minute duration, they occurred onlyone time per day for each response. A
more efficient, and possibly productivearrangement might have entailed reducingthe treatment time and adding mord sessionsper day. This schedule may have alsoguarded a4ainst the possible countereffects produced by unreinforcedapproximation behavior and negativeresponses to the learning equipment.
2'1
.52
53
4f-1'11411j1./.12) insensitivity of 1earni 1 %Ito approximated behavior
The learning equipment was unfortunately andperhaps detrimentally, insensitive toapproximated target responses. This short-coming prevented reinforcement fornear-accurate behavior, and may havecontributed to negative responses towardthe learning equipment such as fussingand crying. It may have also contributedto the changes in state resulting insleeping, possibly indicative of frustration.
3) satiating effects of light display under treat-ment 1 conditions
Light displays under treatment 1 conditions
were continual. The reinforcement for thestandard approaches consisted of tactileand auditory praise. Satiating visual'effects may have contributed to off-taskbehavior, for example, hand-gazing, andhindered motor and associated positiveresponses.
4) difference in strength of reinforcement underdifferent treatment conditions
The difference between the strength oftreatment 1 reinforcement (tactile andauditory praise) and treatment 2
(response-contingent light displays)was not controlled for, and may beresponsible for the differentialbehavior seen in training.
5) pra tice effects
The,advantage of prac ice with targetedhehav*or under treatmeh I may have con-tribute4 to accelerated responding undertreatmen't 2 conditions.
6) percussing effects (postural drainage) ofweight bearing equipment when experimentalinfants were congested
The subjects both had colds during thecourse of the investigation. The weightbearing equipment required that they bepositioned prone over a chest support.
When not weight bearing, the subjects'heads were typically postured downtoward the switch platform. This causeddrainage of congested area from upperrespiratory tract through nasal and oral
cavities.
2,4 )
54
7) dislike of weight bearing equipment
Neither subject appeared to enjoy the weight
bearing equipment. No smiling occurred in
any phase for either subject, and fussingand crying responses were comparativelyhigh. It was not necessary for the sub-jects to use head control during treatment1 to be reinforced for the targeted weightbearing responzte. It was, however,required to view the continuous lightstimulus during treatment 1 and respons#1-
contingent light display during treatment
2. This added dimension, the fact thatapproximated responses were not consequated,
and the percussing effects of the equipmentwhen the subjects were congested may haveall contributed to the high incidences ofnegative behavior during weight bearingtreatment sessions.
The subjects selected for this study had both a
limited awareness of cause and effect relations4ps and an
absence of object-related schemata in their repertoire.
A more salient and perhaps successful reinforcer might have
involved response-contingent interactions with the primary
caregiver. Consideration and control of these variables
would enable isolation of experimental variables and add
clarity to the findings.
Although the generalization of responses was
not systematically probed, information gathered through
informal observations revealed that behavior acquired by
both subjects during treatment generalized into other
activities, such as home and center interactions and
independent, unstructured play situations. These effects
were mcst apparent as the result of training the bilateral
reach/grasp response. Behavior that subsequently emerged
included grasping, banging objects at midline, holding,
visual inspection, and increased visual attending with
both people and objects. Additionally, it seemed
instrumental in decreasing stereotypical behavior in one
of the subjects. Weight bearing training appeared to
promote a quadraped response in subject 2, and improved
protective responses in both subjects.
For the experimental, severely handicanped
infants, contingency training offered a viable alterna-
tive to standard teaching procedures. It may haVe
additionally generated further environmental exploration,
through introducing response-contingent interactions and
the option of active participation and control.
It is evident that contingency training
utilizing learning equipment is at least a feasible
strategy for facilitating and maintaining motor skflls
and their approximations. At most, such training may
advance the understanding that an action produces an
effect. The informal observations of generalized behavior
during this investigation seem to indicate that response-
contingent training served to encourage further
exploration of the environment.
The advantages then, of motor training on
response-contingent learning equipment include increased
and sustained rates of responding, the opportunity for
active control over actions and their consequences, and./
the possibility of promoting the est6lishmeni of cause
and effect relationships. Since learning and motive-
.9-
211
55
56
tion theory suggest that human growth and development is
strongly influenced by active, competent interactions
with the environment, teaching using learning equipment
may represent a progressive and time efficient supple-
ment to developmental programming for the young severely
handicapped population.
57
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25
r)
APPENDICES.
1. Parental Consent Form
2. Diagram of Classroom
3. Brazelton's States (Aapted)
4. Pilot Procedures
S. Pretest Procedures
6. Treatment 1 Procedures
7. Treatment 2 Procedures
8. Diagrams of Learning Equipment:Weight BearingWeight Bearing WiringBilateral Reach/GraspBilateral Reach/Grasp Wiring
25
I
r
A
Parental Consent Form
25 I
,
,
t
6 5
Parent Permission Form
Research Project: Teaching Motor Responses to Multi-Handicapped Infants Using Learning
Devices
I am aware that the purpose of this investigation is to
compare the teaching method presently used in the class-
room and in myhome with a new strategy employing simple
,contingency devices.
I agree that the particular motor responses to be trained
are not presently in my child's repertoire and I see the
relevance of these behaviors in ray child's developmental
progression,
I -understand that all records will be subject to the same
standards of confidentiality as the other records'in the
project, that real naipeg will not be used, and that video-
tapes will be viewed only by the research personnel
particiitating in this project and then destroyed after a
one year period.
I will permit my child to be transported in a private car
to and from school for the training sessions.
I realize that I am free not to participate in this pro-
ject, and that if I agree, I have the option' of
withdrawing my child at any time.
Child's Name Parent's Signature
Parent's Slgnature)
Date
.66
67
Diagram of Classroom
0
WEST
Mirror
MATS
LMotorEquip.
Refrig.
File Desk
Desk File
Camera
01
0rO
rtain
VideoEquip.
Black Curtain
CARPETEDAREA
%TM "NT411OXII.
EAST
2 t )
0
68
69
Brazeiton's States (Adapted)
-
70
Coding State of Arousal: (T. Berry Brazelton Neonatal_Behavioral Assessment Scale1976).
States of Arousal:
Awake States:
3. Drowsy or semi-dozing: Eyes may be open or closed,
eyelids flutteridg; activity level variable, withinterspersed, mild startles from time to time;reactive to sensory stimuli, but response oftendelayed; state change after stimulation frequentlynoted, movements are visually smooth. Fussing may
or may not be present.
4: Alert, with bright look; seems to focus attention on
source of stimulation, such as an object to be sucked,
or a visual or auditory stimulus; impinging stimuli
may break through, but with some delay in response.
Mknimal motor activity.
5. Eyes open; considerable motor activity, with thrusting
movements of the extremities, and even a few spon-
taneous startles; reactive to external stimulationwith increase in startles or motor activity, butdiscrete reactions difficult to distinguish because
of high activity level. Fussing may or may not be
present.
6. Cr in : Characterized by intense crying which is,
icult to break through with-stimulation.
Sleep States:
1. Deep sleep with regular breathing, eyes closed, no
spontaneous activity except startles or jerky move-
ments at quite regular intervals: external stimuli
produce startles with some delay; ,Ippression of
startles is rapid, and state changti are less likely
than from other states. No eye movements.
2. Li ht sleep with e es closed; rapid eye movements canbe observed un er c ose s; low activity level,
with random movements and startles or startle equiva-
lent; movements are likely to be smoother and moremonitored than in deep sleep; responds to internal
and external stimuli with startle equivalents, often
with a resulting change of state. Respirations are
irregular, sucking movements occur off and on.
21;
0
Pilot P /cedures
71
NAME: DATE: PROGRAMMER: Veltman
AREA: Gross Motor PHASE: Reach/Grasp STEP: Bilateral
BEHAVIORAL OBJECTIVE: Subject will, when positioned in a supported sit facing the
apparatus reach towards and grasp steering wheel (one hand on either side) in
bilateral:mmtmata_CRITERION:
MATERIALS
Learning,equipment
PREPARATORY PROCEDURES EXPECTED RESPONSE CONSEQUATION SCORING
POSITION OFCHILD
Supportedsitting incarrier
21;
(1) Connect contingentdisplay
(2) Padding behindshoulders tofacilitate reach
(3) Initial 3 secondfull hand prompt
(1) Subject graspssteering wheelbilaterallyone hand oneither side
(2) No'or incorrectresponse with-in 1 minutetime period
(3) No or incorrectresponsefollowingsecond prompt
(1) Contingent (1) Record fre-light quency ofdisplay response
(2) Full handpromptlasting 3seconds
(3) None
' 6
Pilot
DATE:.NAME:PROGRAMMER:, Veltman
AREA: Gross Motor PHASE: Weight Dearingawm, STEP: Extended Arms.
BEHAVIORAL OBJECTIVE: Subject will bear equal weight on extended arms while in a
prone position partially supported at chest
CRITERION:
MATERIALS PREPARATORY PROCEDURES EXPEdTED RESPONSE
Learning-equipment
POSITION OFCHILD
Pronechest sup-ported byrollSeat beltfastenedaroundwaist
2f; ,
(1) Connect contingentvisual display
(2) Position subject
(3) Administer initial3 second shoulderprompt
(1) Subject bearsweight onextended arms
(2) Subject doesnot respond orrespondsincorrectlywithin 1 minute
(3) Subject doesnot respond orrespondsincorrectly
CONSEQUATION SCORING
(1) Contingentlightdisplay
(1) Record dura-tion ofresponse
(2) Repeat 3secondshoulderprompt
(3) None
2f;
74
Pretest Procedures
NAME: DATE:
AREA: Gross Motor
=,PHASE: Reach/Grasp
Pretest
PROGRAMMER: Veltman
STEP: Bilateral
BEHAVIORAL OBJECTIVE: Subject will, when positioned in a supported sit facing the
apparatus reach towards and grasp steering wheel (one hand on either side) in
CRITERION:
MATERIALS PREPARATORY PROCEDURES EXPECTED RESPONSE CONSEQUATION SCORING
Learningequipment
POSITION OFCHILD
Supportedsitting incarriet
2f;
(1) Noncontingentvisual display(continuous dis-,play) causeaTiiolding circuitlosed on device
with clamps
(2) Padding to facili-tate reach - behindelbows, shoulders
(3) Full hand promptfor 3 second dura-tion
(1) Bilateralreach/graspto steeringwheel
(2) No or in-appropriateresponse after1 minute
(3) No response orincorrect re-sponse aftersecond handprompt
(1) None
(2) Secondhandprompt ,
lasting 3seconds
(3) None
(1) Score byobservationor number ofbilateralreach/graspresponses towheel
2
Ira NAME: 4DATE:
r---Pretest ----1
AREA: Gross Motor PHASEf Weight Bearing
PROGRAMMER: Veltman
STEP: Extended Arms
BEHAVIORAL OBJECTIVE: Stpoject will bear equal weight on extended arms while in a
prone position partial/y supported at chest*
CRITERION:
MATERIALS PREPARATerRY PROCEDURES EXPECTED RESPONSE CONSEQUATION SCORING
Learningequipment
POSITION OFCHILD
ProneChest sup-ported byrollSeat beltholdingaroundwaist
I )1
(1) Noncontingentvisual display(lights on)
4.
(2) Connect lightindicator to sig-nal response atrear of device
(3) Administer initial3 second shoulderprompt, holdingelbows extended
(1) Subject bearsweight onextended arms
(2) Subject doesnot bearweight orequal weighton extendedarms within 1minute
(3) No or inco-rrect responsafter secondshoulderprompt
(1) None
(2) Administersecond 3secondshoulderprompt
(3) None
(1) Record dura-tion ofresponse asindicated bylight at rearof device
11
77
Treatment 1 Procedures
f) -1/..... / .)
NAME:
AREA: GroEs Motor
DATE:PROGRAMMER: VeltmanftWa
PHASE: Reach/Grasp STEP: Bilateral
BEHAVIORAL OBJECTIVE: Subject will, when positioned in a supported sit facing the
apparatus, reach towards and grasp steering wheel (one hand on either side) in
1Watezzl_maltumaata 4NMIOam.awsswNimw*wwm1V1...IsVS.OfxaawrwImMewll/aaMNwwmmmmmw.rm.w
CRITERION: , .....10.10MIIIINE
MATERIALS PREPARATORY PROCEDURES
Learningequipment
POSITION OFCHILD
Im. awarml
Supportedsitting incarrier
(1) Child is seated,supported at hipswith strap
(2) Flexors on insideof forearm aretapped 3 timesapiece
(3) Fingers are givenquick stretch 1
time on each palm-
up hand(4) Dowels are pre-
sented horizontallyrequiring child tograsp (handprompt) or fallback (press chest)
a) palm-up 3 times
b) palm-down 3
times(5) Non-contingent
light disllay
EXPECTED RESPONSE
(1) Subject graspssteering wheelone hand oreither side ina bilateralmovement
(2) Subject doesnot respond orrespondsincorrectlywithin 1minute period
(3) Subject doesnot respond orrespondsincorrectly
wwag-,.1111010
111..0.15
(1) Praise,verbal reinforce-ment
(2) Administersecondfull handpromptfor 3secondduration
SCORING
(1) Count fre-quently ofbilateralgrasps onsteeringwheel
27)
NAME:
AREA: Gross Motor
Treatment 1
DATE: PROGRAMMER: Veltman
PHASE: Weight Bearing STEP: Extended Arms
BEHAVIORAL OBJECTIVE: Subject will bear equal weight on extended arms while in a
prone position partially supported at chest
CRITERION:
MATERIALS PREPARATORY PROCEDURES EXPECTED RESPONSE CONSEQUATION SCORING
Learningequipment
POSITION OFCHILD
ProneChest sup-ported byroll
Seat beltfastenedaroundwaist
a)
(1) Position subjecton forearms inprone position
(2) Pull hips upwardsand backwards oneither side untilsubject assumesa quadrapedposition
(3) Hold for 3 seconds(4) Lower hips(5) Extend arms and
apply pressure toshoulders for 3seconds
(6) Position on learn-ing apparatus
,.
(7) Connect noncontin-gent light display
(8) Administer initial3 second shoulderprompt
(1) Subject bearsweight onextended arms
(2) Subject doesnot respond orresponds in-correctlywithin a 1minute timeperiod
(3) Subject doesnot respondor respondsincorrectly
(1) Praise -verbalreinforce-ment
(2) Administersecond 3,secondshoulderprompt
(3) None
(1) Record dura-tion ofresponse asindicatedby light atrear ofdevice
27 (
Treatment 2 Procedures
2 7 :')
%
80
NAME: DATE:
AREA: Gross Motor
PROGRAMMER: Veltman
PHASE: Reach/Grasp STEP: Bilateral
BEHAVIORAL OBJECTIVE: Subject will, when positioneci-17MarigEFEWirfaValapparatus, reach towards and grasp steering wheel (one hand on either side) in
bilateral movements
CRITERION:
MATERIALS
Learningequipment
POSITION OFCHILD
Supportedsitting incarrier
27.)
111PREPARATORY PROCEDURES EXPECTED RESPONSE
(1) Test contingentvisual display
(2) Padding behindsubjects, shoulderand elbows tofacilitate reach
(3) Initial 3 secondfull hand prompt
(1) Subject graspssteering wheelbilatArally,one hand oneither side
No or incorrectresponse with-in 1 minutetime period
No or incorrectreqponsefollowingsecond handprompt
CONSEQUATION SCORING
(1) Contingentlight dis-play
(1) Record fre-quency ofresponse bycountingoccurrenceof display
(2) Full handprompt for3 secondduration
(3) None
26J
NAME: DATE:
Treatment 2
PROGRAMMER: Veltman
AREA: Gross Motor PHASE: Weight Bearing STEP: Extended Arms
BEHAVIORAL OBJECTIVE: Subjent will bear eaual weight oh extended arms while in aprone position partially supported at chest
CRITERION:
MATERIALS PREPARATORY PROCEDURES EXPECTED RESPONSE
Learningequipment
POSITION OFCHILD
proneChest sup7ported byrollSeat beltfastenedaroundwaist
261
(1) Connect contingentvisual display
(2) Position subject
(3) Administer initial3 second shoulderprompt
(1) Subject bearsweight onextended arms
(2) Subject eitherdoes not re-spond orresponds in-correctlywithin Iminute
(3) Subject eitherdoes not re-spond orresponds in-correctly
CONSEQUATION SCORING
(1) Contingentlight dis-play
(1) Record dura-tion ofresponse
(2) Repeat 3secondshoulderprompi
(3) None
2S.
P
Diagrams of Learning Equipment:
Weight BearingWeight Bearing WiringBilateral Reach/GraspBilateral Reach/Grasp Wiring
283
o
9
83
.-- 45' " ---->
7.0.T.NWEIGHT BEARING EQUIPMENT
2 b 1
1---, / a 0...............
DESIGNED BY:Margaret VeltmanGerald M. Simmons.
ADAPTATIONS:Kelly Edmundson
2 6 )
SelectorSwitch
1 2 . 3
Plug
Note/
PressureSwitches
Both Pressure SwitchesHaVe To Be Activatedkor Light Circuits/Power To Operate.
NoConnections
Child'sLight
Forwardeache
tir Ligh
WEIGHT BEARING WIRING
jforward) 1.
.(center)
Child's lighton.continuously
2. Child's lightoff-
qild's lightAih withpressure sliitch
actiVated
(rearward) 3.
Note: Teacher's light wi4.always light when-ever pressureswitchesare activated
co
Front
BILATERAL REACH/GRASP EQUIPMENT
BUILT BY:Margaret VeltmanGerald M, Simmons
J
4,4
gdapter4:10(Reduces Voltage) ,)
t.
v
,.
\
aFlashlights
andReflector
a
w
,
, #
COnnector
87
Wire 'Switch onSteering Wheel
Adaitor
BILATERAL REACH/GRASP WIRING.
e
'7 :
\
I.
Appendi x F
El ectroni c Apparatus
2 t
4.
1
4
PUZZLE TOY
DESCRIPTION
This puzzle id designed to reward the child with a
seven second burst of lights and sound when he places the
two pieces,in correctly. After the Seven second reinforce-
ment, the child must reMove both pieces and reinstall them
"4\4efore the lights and bell will sound again.\
The piecei-Vill be colored acrylic plastid'about 3"X6" in
size. One will have 'ankular edges, the other will have'rounded
edges . Both pieces will. be a. i" higher than the holes.
The batteries, bell, and control circuits will be housed
in the case as shown above. The case will be made of plywood
and should be strong enough to survive normal kicking around..
4
PROPOSED PARTS LIST
FOR PUZZLE TOY
Electrical ,
8 ktD" cell bactteries (alkaline).
2 battery cases (each 'holds four)
sensitiv.SPDT r4ay.
4200 MFD .Capacitor
1 q, watt intensity Lite bulbs
AutoMbtive turn signal flasher
2 Single pole:, double throw switches
Bell or Buzzer (12 Volt)
'Case Materials
.4.
$9.96
2.58
c\-.. 1.99
3.49,
7.00
4.00
(micro) . 2.68
8.00art/
smaliambunts of colored plastic \
for-lamp lenses and pieces 5.00
plyWood for case 2.00
miss, screws and othen fasteners 3.00
Paint and Finish 3.00 I
TOTAL 52.70Material
Labor t hours at $10.00 . $14.o.00
Total Estimated
Cost: $92.70
0
29 j
tamBbDY PARTS
DOLL TOY
This, toy will be used by an instructor to teach a chiad
"to recOgnize'parts of the body. In the Simple version,
it will cOnsist of a cartoon child made out of translucent
colored sheet plastic mounted on a light box. The instructor
can.control the light with a'hand held switch,. The'child
be asked to point to the cartoon's "hand". If the child
points correctly, (the instructor will push the button switch
and light up the entire 'doll.
Deluxe versiont In this'version each part of the doll will
-have its own light. For exampli, when the child points to
the cartoods head, just the head will-light up. This dedign
requires alight bulb for each part of the body and a 'switCh
for.each light bulb on the instructor's control box. It also
requires that'the light box have partitions Wilt into it to
keep light from Spilling over into unwanted areas.. A 20
body Part model is priced on the.next pge.
to StiAna
blboa CP. tieCcriNee rs
erat tr.2 9 4
PROPOSED PARTSiLIST
FOR BODY PARTS DOLL
(SIMPLE VERSION)
Electrical
4."D" cells forpower supply
1 battery holder,.
(1) 6 volt light bulb
push button switch
1 hand-held cóntrOl box-
Case material
$4.98
$1.29
.79
2.00
1.89
4 io 5 sq ft of colored plastica $15.00
plywood for case . 3.00
miss screws and fasteners . 3.00
paint and finish , 3.00
TOTAL $34.95
Material
Labor 6 hours at $10.00/hotir 60.00
,1
Total Estimated
_Costs $94.95
29.)
PiOPOSED PARTS LIST
FOR BODY PARTS DOLL
DELUXE VERSION)
Electrical
11.
cr
.4 "D" cells for power supply $4.98
1 Battery,holder 1.29
(1) hand held control box 1.89
20 Micro push button switches 9.96
Ribbon cable 20 strand-48" long 18.00
(206 volt light bulbs
20 light bulb so.ckets 6.00
Ask
Case.matei:ials
4 to 5 sq ft bf colored plastic $15.60
plywood for case 3.00
miss. screws and fasteners 3.00
paint and finish 3.00.
Total $74.02Material
Labor. 10 hours at $10.00/hour c-$100.00
Total Estimated
COST: $174.00
4/
//1444L.A.-
ENbiCHECK, MONEY-ORDER, OR
P RCHASE ORDER.TO:
ITEM QTY PRICE TOTAL
2 PRESSURE swrTtH $24.50-
Linda J. Burkhart
8315 Potomac Ave.HEAD CONTizOL SWITCH )6:95
College Park, MD -20740 TOY ADAPTER D CELL 6.95
PLEASE PRINT C CELL' 6.95 .4.
AA CELL , 6.95
NAME9 VOLT
STREET ANY 4 ADAPTERS 4 24.95
BOOK6.00
CITYSTATE ZIP
MO residents add 5%
sales tax t 1
TOTAL
TOY ADAPTER - Thisjoy adapter will fit either of theswitches-described as well as tlie ones.
that you make yourself from the.book described below. SimpTy slide the edapter between the
batteries' of the toy and plug the switch into it% The-toy adapter may be reused for any toyk
the same size batteries.Select toys that have an ON/OFF switch. Complete direttions are
tncluded. Please specify battery size. When electing a remote controlled toy, make sure th,
there is an ON/OFF switch on the control and buy the adapter to fit the size batteries in fhe
control. The sWitch will not be able to control other functions besides ON and OFF. Price
includes postage and tiandling. Sizes: 0, and AA ce11,5 $6.95
NOTE: The 9 volt adapter requiresabout one extra half nche of spaCe in the battery compart
ment. Examine the toy or:radio'before purchasing. Prince includes postage and handling.
Size: 9 volt . . ... $7.95
VAKE YOUR own! - This book describes how to make siMple switches'and toyadaptations easily a
inexpensively. It gNes complete instruction'sand clear
illustrations as well as suggested u
and activities. Price includes postage and handling. HomemadeBattery.Powered To s and
-Educational Devices for Severety Handicapped Children, by Linda J. Burkhart $6.00
OSSB LOW VISION EVALUATION TOOL
p 3
Thefollowing is a tool devised by three visionspecialists from the Oregon State Schoolfor
Blind: Beppie Hello, Patty Troisi, and Debbie Oppel. It was devised in a joint effort to
facilitate a consistedt,ongoingNethod of evaluating both students.at the Sch000r the Bl
and Oreschoolchildren in the home. The information is recorded ip a developmental sequence.
The informationplaced on this evaluation.can then be shared with other educationalprofessior
and opthalmologists/optometristsin efforts to provide a total-child education.
This tool can also be used'as a criterion reference test in that a vision stimulation prograr
be devised for children in the areas they are lacking.orshowing "Low level of performance.
This tool has already beenimplemented at OSSB and has pi-oven to be successful in giving an
organized profile of each student's visual functioning. We hope it will be useful to ybu.
29
Appendix G
San Francisco Infant Program
Student Training Manual
TRAINEES INFORMATION SHEET
To assist trai.nees of various disciplines in jpining the staff of theSan Francisco Infant Program, some basic information is necessary. Please fill
out the enclos'ed form and give it to the cooperating teacher/therapist you areassigned to work with.:
NAME:
PRESENT ADDRESS: PRESENT PHONE:
PERMANENT ADDRESS: PHONE:
DISCIPLINE: (Teaching, PT, etc.):
College/University currently attending:
Student Program level (e.g. graduate, intern, affiliate, underoraduate, etc.):
Dates of Student Placement: To
.Days/Hours to b'e_spent in School:
Previous Trai.ning Placement (with short description of population and nature of
your involvement:
Are there University evaluation forms to be filled out on you?Yes No
If so, who is responsible for thiS?
Who is your student teaching supervisor?
- What competehcies do you hope to gain frop this experience?
List your strengths and weakness as you see them.
0
In case of emergencies, who should we contact?
The San Francisco li-ant Program
The primary goal of the San Francisco Infant Program is to provide early
intervention services to young handicapped and developmentally delayed infants
and toddlers and their families. The philosophy of the program is based on a
behavioral approach to education, as well as a developmental approach.
The San Francisco Infant Program is designed to provide field experience
auitraining for students from the disciplines of early childhood and special
education, occupational and physical therapy, psychology and social work \
Students will be given the opportunity to work with a transdiscipTinai-y team,
participating and observing various disciplines,working together and sharing
expertisb in providing services to individual chilaren. In addition, various
research projects will be carried out in the classroom. Staff members and ,
students will have the opportunity to be involved in these research projects.
Introduction to the San Francisco Infant Program
The San.Francisco Infant 'Program is a service to inflapts and their faMilies
provided in the school district. It is operated 'from a federal grant awarded
to San FrancisCo State University. The program is located at Sunshine School
and serves infants from birth to 18 months and toddlers 18-36 months. The
program provides educational services for each child in all areas of develop-
ment, including fine and gross motor skills, cognitive.and pre-academic skills,
communication and social and self-help skills.
Ten infants and their parents or caregivdrs come to the classroom one day
a deek for three hours. ParentS and teachers plan educational programs for
each child during classroomctime. Parents also work on the programs and
activities at home.
Twelve toddlers, two of whom are non-handicapped peer models, Atend
school three mornings a week for three hours each session. Parents/caregivers
are asked to participate in the program two out of the three mornings. They
also provide home programs and activitei's to their child.
In addition to attending class with their child, parents have the oppor-
tunity to participate in a parent group bi-weekly. Home visits to each
family are also thine on a regular basis.,
San Francisco Infant Program Staff Mpmbers:
Marci Hanson 7 Project Director
Pat Landman Parent Coordinator
Joan LaPoint - Educational Coordinator
Eve Cheung - Head Teacher
Karin Simpson-Schubert - Physical Therapist
Humberto Sale - Spanish Interpretor
MONDAY
,sb
PROGRAM SCHEDUCE'
TUESDAY WEDNESDAY THURSDAY FRIDAY
AM
Toddler
9:00
12:00
PM
Infant
Group B
9:06 -
12:00
Toddier
9:00
12:00
'Toddler
9:00,
12:00
Planning &ReportWriting;
Inservices;'
IndividuilEvaluations
Home Visits
IndividualTherapy
StaffMeeting
(1:00-4:00)
'Staffing
Inservice
Infant
Group A
12:30 -
3:30
Home Visits
IndividualTherapy'
Toddler Class Schedule
9:00 - 9:10 Arrival; Undressing
'9:10 - 9:30 Opiening
9:30 - 9:45 Small Group
9:45 10:05 Small Group
10:05 10:25 Gross Motor/Large Group Activity
10:25 10:50 Snacks
10:50 11:10 Small Group
11:10 11:25 Small Group
11:25 - 11:40 Large Group Activity/Free Play-
11:40 11:50 Closing; bressing
302
0
Responsibili ties of Student Teacher
1. Assist in n'organization of classroom
2. Assist in n planning and implementing small and large group activities.
3. Assist in '1 planning and implementing individual student programs.
4. Assist in -i data collection in classroom and graphing of data.
5. Preparat2, ion oY 'classcoom for next day:
a) Cl ,oard systpm
b) Physi 'cal set-up
c)- Teach .ing materials needed
6. Participa te in trarisdiscipl inary team, eg,i1 follow-through on positioning
and liandl ing recommendations made by Physical Therapist.
7. Assist in Parent straining.
8. Participa te in home visits, 1EP meetings, Evaluation_ segsions, staffings,
9. Attend participate in, staff meetings.an-li
10. Develop t. eaching materials for-the classroom.
e.
General Objectives of Student Teaching,Practicum
Through the student*teaching experience, students will demonstrate
knowledge of:
A. Classroom management and classroom engineering skills for an
early childIpbd class
1) behavior management skills
2) classroom arrangement 4'
3) apvopriate placement of children in a group activity
4) management of chilqren in'a small or large. group
5) grouping children actording to funCtional'levels; behavioral
levels.
B. Development of instructional obejctives and curridulum in selected areas
of early childhood education
1) assessment,procedures
2) data systems
3) 'appropriate materials
4) .appropriate teaching procedures
C. Basic teaching and presentation skills appropriate for an early
childhood clasroom
1) Classroom dynamics/presentation skills.
For exampTe:
a), facial and ohysical gestddes
b). vocal presentation during various activities
c) motivating a group for activity
Teaciping proced4res.
For example:'
a) task preparation and arrangement
b) prompting (verbal and physical) and modeling
c) giving concise directions, and other.cues .
d) evaluation of activity while teaching as well as
after activity is done.
30i
e) preparation and implementation of small ,and large
group acti viti es
reinfqrcement techniques
_other relevant teaching techniques.
D. Participation in a transdisciplinary team.
E. Interactions wi th pa'rents
For exampl e:
1) on home visits
2) setting up instructional prov(ns
3) giving suggestions
4) in parent group meetings
30:3
Weekly Practicum Outline
The Objectiv'e of the Practicum is for the student to gradually assume more
responsibility until s(he is plannihg for and teaching the entire class or
a portion of the entire class for a half-day period. Supervision during
the practicum is provided by both the cooperating teacher and the Project
Directer.(who will bp the major evaluator). Conferences will; the Project
Director, coOperating teacher, and student wtill be scheduled on 6 weekly
,basis or as needed,during the semester.
I. Week One
A. Observation of ClassToom
1. Determine .physical layout of classroom (zones, exits, etc.),
schbol facilities, 'school personnel
2. InspectLand familiarizesoneself with
al instructional materials
b.4 curriculum guides
cl operating instructiohs for equipment
3. Emergency RroCedures
6. Observation, of class and.individual student behavior
1. Observe c lassroom schedule and routilie
2. Learn cilildren's names, grouping for instruction
3. Familiarize oneself with:4 -
a. each chilcrs medical background
` b. current :individualized programming
c. past reports and evaluations (IEP, updated reports)
4. Familiarize oneself with clipboard and ring folder system
used in classrgom.
5. Observe student, parent and teacher behavior in structured
class.room setting.
6. Observe children's behavior during free-time.
306
II. Week Two
A. Hands-.on work with children. --
1. Obsecve and assss ski31 level of one infant an.d two toddlers
in a oiven'area.
2. Determine instructional approach (without teacher's guidance).
3. Dekergrine possible reinforcers; use.of antecedent events.
4. Determimethod of instructional evaluation..
5. Implemen program with two students (toddlers).
B. Spend on morning with Physical Therapist
C. Classroom Management
. 1. Review position.ing and handling recommendations for one
infant and two toddlers with Phystea) Therapist
2. Review classroom management techniques observed and discuss
With cookrating teacher (for all children in classroom)-.^
3. Fami31iarize oneself with:
a) programs being'run in classroom
b) data systems being used in classroom1
c) home programs
4. Review clip board and ring folder system.
5. Assistance in free,play time with individual children and in
. small group activities.
6. Preparation of teaching materials.
III. Week Three
A. Continue to familiarize oneself with classroom schedule and
activities.
B. Clas'sroom Management
1. Implement at least three programs with small group (teacher
prepared).
2. Review positioning and handling recommendations for
AO4 all children.
a. Assist in implementing teacher prepared large group activity.
4. Continue other classroom management activities begun in
previous week.
C. Meet with cooperating 'teacher for informal evaluation.
IV. Week Four and,Pive.
' A. Continue implementation of supervising teacher's prepared small
group activities.
B. Begin planning.(with supervising.teacher) an activity incorporating
goals in one or two *skill areas, for' small group.A
C. Familiarize self with snack time operation.
D. Assist in large or small group Gross Motor Activity Iplanned
by teacher or Physical Therapist)..
V. Week Six
. A. Supervise s'nack time operation'..'
B. Discuss small grourinstruCtion planned independently with.
supervising teacher and implement.
C. Plan and'implement a largq.gr small group. Gross Motor Activity
(with input from Teacher or Physical Therapist).:
b. '-tontinue implementation of .small groups prepared by supervisory
teacher.
E. Attendance at home visit.
F. Plan and implement a group activity for tHe Infant classeS
(with input from teacher).. A
1,*I. Week Seven and Eight
A. Plan and implement a lai.ge group activity (with input from
supervising teacher and Physical Therapist).
B. Plan and implement a Fine Motor activity and a Communication
activity (with input from supervising racher and Physical Therapist).
C. Contifte implementation of small group activities prepared by
supervising teache'r.
D. Mid-Term Evaluation.
VII. Week Nine and Ten
A. Plan one morninglaith edt$re toddler class independently,:utilizing
,other staff members and teacher as observer. '
B. Continue plahning selected small group activities.
C. Attendance at a Parent Med.ing.
f
VI Week El even
Plan all mornings for entire toddler class.
. .1. Teacher as observer
B. Continue planning selected small ,grourttivities.
C. Plan for b4h Infant classes.
IX. Week Twelve and Thirfeen
A. Plan all mornings for entire toddler class.
1. Plan One morning utilizing teacher and other staff members.
2. PIan two mornings witll teacYfer out of classroom, making
only spot observatipns,
Plan for both Infant classes.
C. Assess student teachinglexperience.
I .
303eA
qt.
'6
FACTOR*RATED
,
RATING ASSIGNED
r
5. Sets reasonable behavioral objectives i 2 3 4 5 '1
45. Programming for individual academic
behaviors 1 2 4 3 4' 5
7. Programming for individual social
behaviors 1 2 3 4 5
8. Programing for group academic
behaviors 1 2 3 4 '5
9. Programming.for group social behaviors 1 2 3 4 5
10. Uses programs that are appropriate .1 2 3 4 5
11. -Uses programs that are efficient 1 2 3 4 5
12. Ability to carry out designed programs 1 2 3 4 5
13. EvaluatidW of programs 1 2 3 4 5
14. Planning for aides and/or para-
professionals 1 2 3 4. 5 ,
15. Vocal presentation appropriate 1 2 3 4 5
16. Reinforces appropriately 1 2 3 4 5
17. Uses effective reinforcers 1 2 3 4 5
-18. Is i-einforced by students' performances 1 2 3 4 5
19. General knowledge of academic mal....v..ials 1 2, $ 4 5
Selection of academic materials 1 2 4 rJ
.20.21. Utilization of materials 1 ,2 3 i 4 5
22. Utilization of time 1 2 3 4 rJ
23. Ability to administer classroom tests 1 2 3 ,4 5
24. Classroom control ..) 2 3 4 5
25. Classroom enginnering (seating
arrangements, etc.) .1 3 4 5
26. Follow-through on established
programs.
,
1 2 3 4 5
27. Consistency 1 . 2 3 4 5
C. ADDITIONAL COMMENTS
3 t
Student Teacher
Cooperating Teacher
'Date
EVALUATION
Rate by circling the appropriate number:,
(1) Excellent (2) Good (3) Satisfactory (4) Fair, 4
(5) Needs Help,
FACTOR RATEDRATING ASSIGNED
A. GENERAL ATTITUDE
1. "Enthusiasm" fo'r teaching
2. Ability cpr self-evaluation
3. Accepts responsibility -
4. Adjusts to new situations
5. Exhibits initiative
6. Reaction to criticism ,
7. Asks relevant questions about students
and their behaviors
8. Asks relevant questions about techniques
and methodology .used in class.
9, Consistent daily preparation
10. Performanceunderstress(crisis situations)
11. interaction with colleagues in non-
instructional setting
12. Interaction with colleagues
professionally.13. Interaction with parents
14. Interaction with students in free
(unstructured) time
B. CLASSROOM PERFORMANCE
1. Uses varied, stimulating learning
situations2. Gives clear, concise directions
3. Identificati-on of behaviors for
modification4. Collection of data
1 2 3 4 5$
1 2 3 1 . 5' '
1 2 3 4 5 '
1' 2 3 4 5.
1 2 3 4 ,5
1 2 3 4 6m
1 -2 \ 3 4 5
1 2 3. 4..
1 2 3 4 5
.
1 2 3 4 5
1 2 3 4 5
1 2 3 4 5
1 2 3 4 5
1 2 3 4 5
1 2 3 5
1 2 3 4 . 5
1 2. 3 4 5
1 2 3 4 51
a
* adapted from "Madison Metropolitan School Districts Early Childhobd
Studeint Trainitng Program".
4
Appendix H
HANSON, M.J . A model for early intervention wi thcul tura 1 ly i dverse single and mul tiparent fami 1 ies .TECSE, 1981, 1(3) I 37-44
..
"'"\
. .1
A model for early intervention withculturally diverse single and multiparent
families
4.
Marci J. Hanson, Ph.D.DirectorSan Francisco Infant ProgramAssistant ProfessorDepartment of Special EducationSan Francisco State UniversitySan Francisco, California
Maria, a 14-month-old infant, was referred toan early intervention program at 7 months of agebecause she was exhibiting -nuscle stiffness anddevelOpmental delay probably linked to birthcomplications. At the urging of the family pedia-trician and because of Marie's extreme irritabili-ty. her parents agreed to consider pursuing inter-vention services. Finding appropriate serviceswas a difficult task, since membera of this Latinfamiiy speak only Spanish and because bothparents are unempioyed and with limited finan-cial resources. The parents also have two otheryoung children in' the home, one of whom isMaria's twin. A program was located that offeredservices at no coat to the family in their nativelanguage. Though Maria's mother ahowadesire to participate in the early interventionprogram and expresses her thanks for the assis-tance ahe receives, she frequently ia unable tobe involved becauae of reported restrictionsplaced on her by her husband. (She also hasreported being verbally and physically abusedby her husband.) The staff of the early interven- ,tion program is working with a number of socialservice agencies in the city to secure appropri-ate and comprehensive services ix Maria andher family.
TECSE. 1981, 1(3). 37410271-1214/81/0013-003782.000 1981 Aspen Systerru Corporation
313
37
TOPIcS IN EARLY CHILDHOOD SPECIAL EDUCATION / OCTOAER 1981
38 Shurell is a 2V2-year-old toddter in the earlyintervention program. Her happy disposition and
well-develoged social skills ensure positiveinteractions with her peers and teachers. Shurell
has been diagnosed as hemiplegic and shows a
definite need for therapy and, training, particu-
larly in motor and language development. Her
father, an unemployed disabled Vietnam veter-
an, is a single parent. As her primary care giver,
he brings her to school three timea a week and
performs training activities with her al home on a
daily basis. Shurell appears to be benefiting
from her father's teaching and their-involvement
in the early education program, as indicated by
her developmental gains.
Humberto and Stiirley were required by a court
order to enroll their son, Frankie, in an interverk
tion program. Frankie is a severely multiply'handicapped 2-year-old, whose disabilities ale
linked to a head injury at 4 months of age due to
alleged child,abuse. Frankie's health is good,
and no other accidents or injuries have occurred.
Frankie attends the program with one or both
parents: However, participation is somewhat
irregular, reportedly owing to family ilifficulties.
The family lives in the home of Humberto's moth-
er, who is Latin and Spanish-spesking. Shirley
has become proficient in Spanish, since thelanguage is spoken at home. Humberto and Shir-
ley report marital difficulties, and Shirley periodi-
cally leaves the home. Frankie's grandmother
assumes major responsibility for basic care-giving tasks (e.g., feeding, bathing). Shirley inui-
cates that she is excluded from care-giving
responsibilities; Humberto reports that she isincompetent and unwilling to perform theseresponsibilities. Given the volatile nature of the
family structure, the intervention saaft works
closely with all family members and with other
agencies serving this family to ensure compre-
hensive and consistent care for Frankie.
Amy's established, middle-class familyboasts that all members of the immediate family
live close by. Amy was born prematurely 3 years
ago at approximately 26-weeks gestational age.
Her birth was surrounded by severe complica-
tions necessitating hospitalization durin the 3months following her birth. At 13 months she was
,
referred by a pediatrioian.to an early intervention
program with the accompanying diagnosrs ofdiplegia, visual impairments (retrolental fibrqpla-
sia), and general developmental delay. Amy's
parents have been hry active in the infant andtoddler program, attending parent meetings andworkshops, bringing Amy to the program regular-
ly, and performing learning activities with her on
41 daily basis at home. Arriy's grandmother,uncle, and lther are to be applauded for theirtraining efforts when Amy's mother was confined
i8 lied with her second high-risk pregnancy. The ..btrd work of this family is reflected by the gains
AVny has made across all areas of development.
(Note: The names and identifying family char-
acteristics of the actual families on which these
Cese study examples are based have been
changed.)
THEgafour families participate in the
same Intervention program for develop-mentally delayed infants and toddlers. The
brief case studies highlight the tremendousAiversity of families served by a typical earlyintervention program in a large metropolitan
area. How does one program accommodatediverse families, each of whom represents awide range of needs and priorities?
A model for parent involvement thatfeatures four components for serving variousfamilies is implemented through the SanFrancisco Infant Program, a federally funded
(Office of Special Education,, Department of
Education) program for handicapped and -at-risk" children from birth to 3 years of age.
Families participating in this' early interven-
tion program are representative of the diverse
population of San Francisco; races and.
cultures represented include white, black,
Asian, and Latin families.The San Francisco Infant Program com-
bines center- (public school) and home-based
service delivery systems in a transdisciplinarymodel. Pasents (or care givers representing the
parentt) attend the program regularly withtheir children and also participate in periodic
,
\
31,4
\home visits by project staff. This participationis required for a child's admission to theprogram for several reasons. First, Childrenattend the program weekly for several short
time periods, leaving the majority of thechild's time spent-in the home or at nonschoolactivities. Second, to change a child's behav-ior, training must also occur in the othersettings outside the school. Third, trainingfocuses on appropriate positioning and han-dling of children and consistent responding to
* the child's actions, necessitating the activeinvolvement of the children s care givers.
Numerous position papers and studies haveestablished the need for active parent partici-
pation in early education programs. Therationale for parent involvement provided bythese studies centers on the amount of timespent with the child, the need for consistentcaring for the child, the quality of parent/child interactions, the reinforcing value of the
parent, the cost effectiveness of parent-deliv-ered services, and the success of parents inproducing change through their trainingefforts (Brickbi & Bricker, 1976; Lillie &Trohanis: 1976; Vincent 4 Broome, 1977).
Thus parent involvement is viewed as a criti-cal component of the San Francisco Infant
Program. ,
MODEL DESCRIPTION
The San Francisco Infant Program featuresseveral components of parent involvement,including classroom instruction on infant skill
training and handling, home-training activi-ties, counseling and support services, and thepresentation of new information materials.
Training in the classroom
The focus of the center-based component of
the San Franciv,o Infant Program is on assist-
ing parents to correctly position and handletheir children, teach their children new skills,
. A MODEL FOR EARLY INTERVENTION
r
The focus of the center-basedcomponent is on assisting parents tocorrectly position and handle theirchildren, teach their children newskills, and effectively interact withtheir youngsters.
and effectively interact with their youngsters.This is accomplished through teacher/thera-pist demonstration of new techniques, system-
_atic feedback to parents on their performanceof infant training programs, and consultationwith parents on goal setting, child develop-
ment, behavior management issues, and
scheduling.-
Shortly after a child begins the program,staff and parents meet to develop an individu-alized education program plan for the child.During this meeting staff members presentthe results of initial child evaluations andclassroom observations and together with theparents develop short- and long-teirn educa-tional objectives. At this meeting parents also
develop objectives for their own involvementby indicating their needs on a Parent Involve-ment Plan (PIP). (For further information onthe PIP, see Brackman, Fundakowski, Filler,
li Peterson, 1977; Filler & Kasari, 1981.)Parent needs ranging from medical and trans-portation services to the need for it' struction inteaching infants specific skills' e identifiedon the PIP, and a contractual arringement formeeting those needs is agreed on staff and
parents. ,Since all parents desired to learn more
about teaching their children, this is the majoremphasis in the classroom. Children in theprogram are divided on the basis of chrono-logical age into two groups: infants and tod-dlers. Infant's attend school for one 3-hoursession per week, accompanied by a parent orcare giver; toddlers, such as Shurell, attend
31 n,
,
39
TOPICS IN EARLY CHILDHOOD SPECIAL EDUCATION / OCTOBER 1981
.
40 school three mornings per week. Parents oftoddlers remain for the class program on twoof the, three mornings and use the third dayfor respite. During classroom time teachersand therapists meet with parents individuallyand in small groups to derive.new teachingobjectives and'plans for the children and toreview the children's,trainink programs.
The exchange of information between staffmemberrand parents is facilitated by the useof a family notebook in which all plans aredetailed. Parents perform training activities athome on a rlaily basis and collect data usingforms provided in the notebook. The datacollection system is a simple procedure inwhich a chart is produced as data arerecorded, allowing the parat to determinethrou4h visual inspectiori if the program isproilucing change. The data system used is themodel described by Hanson (1977).
Parents dre encouraged to integrate theirteaching activities into daily routines, such asdiapering and feedhig, and implement theprograms and activities throughout the daywhen the child is an alert learner. Shure Wsfather, for example, regularly brings hisdaughter to school, where he is assisted in
*developing specific programs for her. Thoughhe is rather shy and nondemonstrative, Shur-efl's progress through the training programsindicates the commitment of her father tocarrying out and recording the home activi-ties. Not all parents are regularly able to workWith their children or collect extensive infor-
mation as Shure Ws father does. Therefore thenumber and type of training activities as wellas recording procedures 2re individualized'according to each family's needs. Multilingualstaff provide information to participatingpatents from the Latin and Asian communi-ties.
Additionally, though one-to-one instructionis utilized when necessary in the toddlerprogram during classroom time, much of theinstruction is performed in small groups to
better prepare children to benefit from andsucceed in integrated preschool and kinder-garten settings when they "graduate." Inter-ested parents in the toddler gccup also receiveadditional instruction on how to plan andmanage small group activities. Parent inser-vice workshops are held periodically to trainparents in the activities at which they wish tobecome proficient. Activities range from read-ing stories to children and planning flannelboard story presentations to teaching small.groups of' childfen to discriminate and labelobjects. Thus parent participants in the San
Francisco Infant Program receive systematicinstruction in specific infant skill training fortheir child and are provided the opportunityto acquire additional skills in classroom teach-ing and managing small groups of children.
Assistance in the home 4.
The home component of the San Francisco-Infant Program also focuses on active parentinvolvement. Home visits to program familiesare periodically made by all staff members;the schedule for these visits is determined onan individual basis depending on family needand desire for home visits. On the average,families are visited once per month.
Given that family members are activelyinvolved in child teaching through the class-room component and that home-teachingprograms are developed during that time, thepurpose of visits to families at home is to
discuss special problems or concerns, reviewchild-training programs, and adapt goals andmaterials as dictated by family circumstan'cesand home settings. Certain child-trainingneeds are also more easily and appropriatelytaught in the home using the family's materi-als and following the schedule.. Working with families in their homes alsoallows staff members to better understand thefamily's cultural values and life style so thatthisinformation can be used to develop educa-
)
,
\
w
tional plans for the child. In addition, if the
family is not English speaking, conversation
betweep family members and staff members,
who may be less fluent in the family's native
language or who must rely on a translator,
may be held in a less structured environment
where more individual time can be taken with
the family to fully discus:: their concerns and
receive feedback from them. For example,Maria's mother is able to more fully partici-
pate in the home than the school component .
aof the program given the restrictions placed
on her by her husband. Since she speaks Span-
ish, the home visit provides an opportunity for
her to express herself fully at a time when staff
members can focus solely on her.
The final and perhaps most important
purpose in considering a home-based compo-
nent to an early intervention program is the
involvement of pach family member. A home
visit is an opportunity for staff members to
meet with siblings and a parent or parents
who are unable to meet during the classroom
day because of their schedule. The home visit
program component was of special value to
Amy's family, for instanCe, when all family
members had to work together to. ensure
Amy's continned trainiAg at the time when
her mother's pregnancy prevented her active
involvement. As demonstrated by Amy's
family, participation by all family members in
employing Ira, g strategies and in under-
standing aspects X, the child's developmentensures more comp ete and consistent assis-
tance and response to the child.
Parent support activities
Many parents are faced 1:vith difficulties
(e.g., marital problems, serious illness, unem-
ployment), which must be alleviated before
they are ahile to become fully involved with
their child's training. Even in families free of
such stress, concerns that dictate a need for
support services may arise.
A MODEL FOR EARLY INTERVENTION
Though not adequately staffed to counsel , 41
and assist families' in many of these service
areas, the San Francisco Infant Program has
developed several strategies to accommodatefamily needs that do not directly involve thechild's education. First, one staff member, theiparent program coordinator, assumes respon-
sibility for providing direc.t assistance to
parents. This assistance varies from perform-
ing an activity with the parents (i.e., filling out
an application for services) to giving parentsinformation on available-resources such as lists
of babysitting referral agencies, national and
state agencies serving handicapped childrenand their families, and local social serviceagencies (e.g., welfare, mental health).
In addition, parent support groups meetbimonthly for an hour while children are in
the classroom. Since children are grouped by
chronological age, parents attend suppbrtgroups with other parents of children of the
same age init with different disabilities. The
content of the meeting is deterMined by the
parents. Parents of the youngest children have
used the groups as a comseling situation,exploring feelings about having a handi-capped child and devising strategies for
handling relatives' and strangers' responses to
and inquiries about the child (e.g., What do
you tell a stranger on the bus who asks why
your child doei not walk?). Parents of thetoddlers requested more structured discussions
focused on topics such as discipline or behav-
ior management and schbol placement for
children aft& graduation from the infant/toddler program. Parents' evaluations (anec-dotal feedback and responses on a parentsatisfaction questionnaire) indicate .-these
groups .are beneficial, and high attendance
rates even under difficult circumstancessuggest they are a meaningful experience.
A third support service component is the
structured review of children's programs atperiodic meetings of the infant program staff,
the parents, and all social service,a encies in.
t" c,,
,
TOPICS IN EARLY CHILDHOOD SPECIAL EDUCATION /OCTOBER 1981
.1
t.
42 the community that are involved with thefamily. At these meetings, organized by theirifant program, staff members present areport on the child's development andprogress, and all agencies discuss serviceprovisions fop the family. These meetingsoften represent the first time that varioussocial service agency peisonnel have met One
another and coordinated services. For families
such as Frankie's, this coordination becomescritical as a means of ensuring adequate child
care and rhay involve additional meetings orphone calls as necessary to arrange services.Thus the San Francisco Infant Prograni servesas the broker or coordinator in finding neededservices for families and for establishing coop-erative ties and plans among agencies provid-
ing those services.
Parent workshops
Having a young child with developmentalproblems is a new experience for most parentsand is fraught with anxieties and questions..Many parents share the same need for moreinformation in specific areas. In order toprovide information to all participants in the
program and involve all family members Whomay wish to attend, the San Francisco In /antProgram sponsors a series of optional work-shops held in the evening. Workshop. topics
are chosen by families in the program andhave' included legislation and legal issues
related to school services for handicappedchildren, language development, geneticscounseling, behavior management, and com-mon medical emergencies..
As with other program componerits, staffmembers furnish multilingual written materi-als or translations as needed and facilitateparticipation by organizing services such .astransportation. Parent workshops provide asystematic and efficient method for pre-senting new information, a time for parents tosocialize and get acquainted, and also a means
of involving family members who are unableto attend daytime adivities.
STAFF RESPONSIBILITIES,
.
The staff of the San Francisco InfantProgram include the following members: ahalf-time project director, a quarter-timeparent program coordinator, and a fbll-timeeducational coordinator, teacher, and physicalltherapist. A psychologist, pediatrician, and \cOmmunication specialist also consult for theproject. Staff members are representative of
' the cultural groups served in the city and.mostare bilingual, which ensures tbat culturallydiverse populations can be served by theproject.
All staff members, regardless of their arcaof expertise, work directly with parents. Theproject emphasizes a transdisciplinary ap-proach in that each team member practices-role release! by training others in theirspecialty area. Parents are active members-ofthis team. Activities are performed by all staffmembers in the classroom and in the home.The project directoi manages the system toensure that the parents' needs are met and allstaff members and parents are activelyincluded. .
Through the Parent Involvement Plan, thestaff members of the San Francisco InfantProgram enter into an agreement with theparents to assist them with identified needs.Many components for parent involvement areoffeted to families. Theie ieclude training inthe home and classroom settings, parentsupport 'groups, referral services, workshops,and frequent counseling and discussions withfamily members. All activities are structuredto meet the needs of families from variouscultures and family constellatiqni *The InfantProgram services are evaluate by analyzingthe number of parent object is met andparent satisfaction with the services provided.
31 0
s
1
,
,
it /
-
Parents, especially those of very young chil-dren, bear responsibility for almost all aspectsof the child's life. Long before schools', peers,and other social institutions exert an influence
on the developing child, parents must play themajor roles needed in raising a child. Thoughprogram goals typically focus on 'assistingparents in these roles, different parents willparticipate to various degrees, depending onfamily necds. Such factors as single parent-hood, needs of other children in the family,illness, employment, cultural factors, maritaldifficulties, or financial probleins mayinfluence the degree of any parent's involve-rnent at a given point in time.
In addition, programs must be able toaccommodate the shifting needs of families,
Long before schools, peers, and othersocial institutions exert en influence onthe developing child, parents must,playthe major roles needed in raising achild.
reflected by changes in American life style.For example, recent data compiled by the U.S.Census Bureau showed an increase from 5.6Million to 8.5 million m the number of house-holds headed by single women. This reportalso indicated that families maintained by
women with no husbands fared less welleconomically than others and had a medianincome significantly below thdt of the national
REFERENCES
13rackman, B., Fundakowslci, C., Filler, J.W., Jr., &.Peter-
son, C. Total psogramming for severely/profoundlyhandicapped young children. In B. Wilcox (Ed.),Proceedings of the Illinois Institute for Educators ofthe 'Severely/Profoundly Handicapped. Springbeld,Ill.: Illinois Office of Education. 1977.
A MODEL FOR EARLY INTERVENTION
average for all families. Thus early interven- t 43tion program models must present a flexibleapproach to type and degree of parentinvolvement.
Intervention programs, particularly those inmetropolitan areas, also must be able lo offerservices appropriate to a wide variety ofcultural/ethnic groups. In San Francisco, forexample, categorizatfbn of the population byethnic group and race from current dab, (1980U.S. Census Bureau) estimates that 11% of thepopulation is Black, 22% Asian, less than 1%Native American, 46% White, 14% SPanish-American, and 7% other ethnic groups. Froma program development perspective, issues inserving a culturally diverse population includeprovidistig services to families in their nativelanguage, acknowledging family values andpriorities dictated by the culture, and incorpo-rating training into the family's defined rolesfor parents and children (e.g., a matriarchalfamily structure wbere the mother assumes allresponsibility for-child-related activities andthe father does not actively participate).
No program can be expected to satisfy allcommunity needs. However, given the estab-lished practice that parents can and should bean integral part of an early intervention effort,models specifying levels of parent involve-ment must present a .spectrum of services tomeet parents' needs and a flexible approach tothe type and degree of parent involvement atany given point in time. The underlying prin-ciple dictating services available for parentsmast be that those services are in the best
interest of the child.
11.., ,Bricker, W.A., & Bricker, D.D. In T.D. Tjossem (Ed.),
Intervention straiegie,s for high risk infants and youngchildren. Baltimore: University Park Press, 1976.
Filler, J.W, jr., & Kasari, C. Acquisition, maintenanceandgeneralization of-parent.skills taught with two severelyhandicsepped infants. Journal of the Association for
TOPICS fN EARLY CHILDHOOD. SPECIAL EDUCATION / OCTOBER 1981
Severely Handicapped, 1981, 6, 30-38.
Hanson, M j. Teaching your Down's syndrome infant: A
- guide for parents. Baltimore: University Park Press,
1977.Lillie, D.L., & Trohanis, P.L. (Eds.). Teaching parents to
tea 'h. New York Walker, 1976.
1.
Vincent, 14., & Broome, K. A public school servicedelivery model for handicapped children between birth
' and five years of age. In E. Sontag (Ed.), Educational
programming for the severely and profoundly handi-capped. Reston, Va.: Division on Mental Retardation,The Council kr Exceptional Chaen, 1977.
3 1.
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00.
ati